SIR 2024
Embolization
Vincent Vidal, MD, PhD
Full Professor, Head of Department
University Hospital Timone, France
Financial relationships: Full list of relationships is listed on the CME information page.
thibault Agripnidis, MD
resident
Aix Marseille university, France
Disclosure information not submitted.
Vincent Nail, PHARMD
Nuclear Physician
Aix Marseille university, France
Disclosure information not submitted.
pauline brige, PhD
research coordinator
Aix Marseile University, France
Disclosure information not submitted.
Benjamin Guillet, PhD, PHARMD
Professor
Aix Marseille University, France
Disclosure information not submitted.
We aim to evaluate in an animal model the safety and efficacy of a new eco-friendly, agar agar-based permanent embolization agent (EmboBio®) for intra-arterial use.
Materials and methods:
Ten pigs were embolized with one EmboBio Torpedoes (5x5x10mm) (6 lower polar renal arteries and 6 lumbar arteries), with EmboBio slurry (6 lower polar renal arteries and 6 lumbar arteries) and with one nylon fibered coils (5mm diameter – 15 cm) (8 lower polar renal arteries and 8 lumbar arteries).
Technical success was defined as a complete occlusion with no residual flow in DSA. Short-term endpoints included safety (non targeted-embolization), ease of use (embolization preparation time, occlusion time), and DSA controls at day 7, month 1, and month 3.
To assess tissue reaction (inflammation) from embolization, 18FDG PET-CT and histological study were performed.
Results:
One emboBio torpedoes achieved persistent occlusion at month 3 for all kidney and lumbar embolization (n=12/12).
Slurry had technical success for 6/6 kidney embolization but showed partial recanalization in 4/6 at day 7 and 1/6 total recanalization at month 1. Only 1/6 had persistent occlusion at month 1. Slurry lumbar embolization had 2/6 partial recanalization at day 7 and 4/6 at month 1.
Control coils had technical success for 8/8 with complete occlusion at day 1. For kidney embolization with one coil, only 2/8 showed persistent occlusions at day 7 and 1/8 at month 3. For lumbar embolization with one coil, only 3/8 had persistent occlusion at day 7, 1/8 at month 3.
No off-target embolization occurred. Time to total occlusion after EmboBio® torpedo release was significantly faster than coils (EmboBio®: 4.25±1.8 s; Coils: 347.5±178 s; n=8; P=0.0002). A non-significant trend toward faster preparation time was seen (coils: 151±60.7s; EmboBio®: 95±14 s; P=0.0002, n=8).
PET study showed no significant difference inflammation between Embobio and coils (EmboBio: 8.56.10-6 ±9.3.10-6 %ID/mm3 ; Coils: 4.36.10-6 ±3.0.10-6 %ID/mm3 ; P=0.5).
Conclusion:
Permanent dry foam comprising agar-agar is effective for arterial embolization. On animal model, one 5 mm Embobio torpedo demonstrates a faster and more persistent occlusion than one 5mm fiber coil.