embo 优于pva颗粒-肾动脉-猪模型.pdfVIP

Relative Rates of Blood Flow Reduction During Transcatheter Arterial Embolization with Tris-acryl Gelatin Microspheres or Polyvinyl Alcohol: Quantitative Comparison in a Swine Model Robert T. Andrews, MD, and Christoph A. Binkert, MD PURPOSE: To determine whether two commonly used embolic agents have differing rates of blood flow reduction during transcatheter embolization of the renal arteries in an animal model. MATERIALS AND METHODS: The renal arteries of 10 pigs were embolized with either polyvinyl alcohol (300–500 or 500–700-m) or tris-acryl gelatin microspheres (300–500 or 700–900-m). Equivalent unit doses of each agent were suspended in 40 mL of fluid and injected in 1-mL aliquots for 20 mL and then in 5-mL aliquots for 20 mL. Blood flow was measured after each aliquot with an intraarterial Doppler flow wire placed through the embolization catheter. RESULTS: Renal arterial blood flow was most rapidly and reliably decreased by 300–500- and 700–900-m micro- spheres, both of which had achieved 90% reduction from baseline flow after the injection of 6 mL of suspension. An equivalent reduction in flow required 25 mL of 300–500-m PVA suspension and 30 mL of 500–700-m PVA suspension. The reduction in blood flow with microspheres was significantly greater (P .05) than that with PVA between 5 and 19 mL of suspension delivered. Differences between larger and smaller particle sizes of the same agent were not statistically significant. CONCLUSIONS: Tris-acryl gelatin microspheres reduced renal blood flow more quickly and reliably than did PVA. The type of agent used in embolization had a greater impact on the rate of flow reduction than did particle size in the range of sizes tested. J Vasc Interv Radiol 2003; 14:1311–1316 Abbreviation: PVA polyvinyl alcohol POLYVINYL alcohol (PVA) has long because PVA is hydrophobic and has ids and a positive surface charge, c