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Cardiovascular system
Published in David A Lisle, Imaging for Students, 2012
For vascular embolization, the embolic material is delivered through an arterial catheter, either a standard diagnostic angiographic catheter or one of a number of specialized superselective catheters. These include microcatheters, which can be coaxially placed through a larger guiding catheter to gain distal access in small arteries. Embolic materials include:Metal coils with or without thrombogenic fibres attachedParticles such as polyvinyl alcohol particlesGlue: superglue acrylatesDetachable balloons: latex or siliconGelfoam pledgetsAbsolute alcoholChemotherapeutic agentsResin microspheres loaded 90yttrium.
Review on the current treatment status of vein of Galen malformations and future directions in research and treatment
Published in Expert Review of Medical Devices, 2021
Panagiotis Primikiris, Georgios Hadjigeorgiou, Maria Tsamopoulou, Alessandra Biondi, Christina Iosif
As for the functional outcome, Berenstein et al. [3] reported 66.6% (30/45) of patients who were neurologically and developmentally intact presenting a score of 4 in the scale suggested by Jones et al. [101], 20% (9/45) had a score of 3 with mild impairment, and 8.9% (4/45) had a score of 2 with moderate impairment [3]. The authors reported radiological cure in 82% of patients (37/45), with 13,3% (6/45) of patients being still under treatment and 4,4% (2/45) mortality. Yan et al. [32] reported in their review and meta-analysis of the literature, complete occlusion in 57% (95% CI 48%–65%; I2 = 68,2%) of cases and partial occlusion in 43% (95% CI 34%–51%; I2 = 70.7%) of cases. Out of 667 patients who underwent embolization between 1987 and 2014, the authors reported, based on the 5-point scale according to Jones et al. [101], a good outcome (scores between 4 and 3) in 68% of cases (95% CI 61%–76%; I2 = 77.8%) and a poor outcome (scores of 2, 1, 0) in 31% (95% CI 24%–38%; I2 = 75.6%).
Preparations and properties of drug-eluting embolization microspheres based on modified gelatin
Published in Soft Materials, 2018
Liping Zhang, Ming Liu, Tian Qi, Haili Zhou, Caihua Ni
Liver cancer is a common malignant tumor with high morbidity and mortality (1,2). In traditional chemotherapy methods, high-dose drugs flow through the body, which causes severe toxicity to the body (3) including myelosuppression, nausea, mucositis, hair loss, vomiting, and so on. Arterial chemoembolization (TACE) is considered an effective mean of treating cancer patients in the later stages (4) and this method is widely used in the clinical interventional treatment of liver malignancies. In this treatment a embolization agent is introduced into the blood vessel via vascular minimally invasive surgery (5,6). The embolization agent clears the nutrient and oxygen supply of organs, tissues or tumors by blocking blood flow for inhibiting tumor growth (7). Drug-eluting microspheres (DEM) were proposed in the 1980s and commercialized around 12 years ago, the first reported commercial product being DC Bead (8). The principle of DEM in arterial embolization is to block the tumor-feeding artery to starve the tumor of nutrients and oxygen, while delivering an anticancer agent locally to the tumor sit, and to remarkably increase tumor drug concentration (9,10). Currently commercial available DEM are polymer hydrogels and are non-biodegradable (11). Embolic agents that appeared recently in the European market are composed of polyvinyl alcohol and sodium acrylate (12). The structure contains a large number of carboxyl groups which can load positively charged anticancer drugs such as doxorubicin hydrochloride (Dox) and irinotecan hydrochloride (13,14).