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Liquid 2-poly-hydroxyethyl-methacrylate embolization of experimental arteriovenous malformations: feasibility study
Joachim Klisch1, Lin Yin, Flavio Requejo
1Section of Neuroradiology, Department of Neurosurgery, University of Freiburg, Germany.
AJNR. American Journal of Neuroradiology
|March 20, 2002
Summary
2-poly-hydroxyethyl-methacrylate (2-P-HEMA) shows promise as an embolic agent for treating arteriovenous malformations (AVMs) in swine. Pure 2-P-HEMA demonstrated feasible and reproducible embolization with long-term feeder occlusion in most cases.
Area of Science:
- Interventional Radiology
- Biomaterials Science
- Vascular Surgery
Background:
- Arteriovenous malformations (AVMs) pose significant treatment challenges.
- Developing effective embolic agents is crucial for AVM management.
Purpose of the Study:
- To evaluate 2-poly-hydroxyethyl-methacrylate (2-P-HEMA) as an embolic agent for swine AVMs.
- To assess the safety and efficacy of 2-P-HEMA in embolizing AVMs without causing brain damage.
Main Methods:
- Surgical creation of experimental AVMs in seven mini swine.
- Embolization using pure liquid 2-P-HEMA or 50% 2-P-HEMA mixed with tungsten for radiopacity.
- Angiographic, CT, and MR imaging for follow-up and complication detection.
- Histopathologic examination to confirm occlusion and assess tissue response.
Main Results:
- 2-P-HEMA was injectable via microcatheters with reproducible technique.
- Radiopaque 2-P-HEMA allowed controlled nidus penetration.
- Pure 2-P-HEMA achieved long-term feeder obliteration in five of six AVMs.
- One case of infarction and one case of vasospasm with subsequent recanalization occurred.
- The 50% 2-P-HEMA group experienced embolic material in the circle of Willis, leading to death.
- No significant inflammatory reactions were observed.
Conclusions:
- Experimental embolization of AVMs with radiopaque pure 2-P-HEMA is technically feasible in swine.
- 2-P-HEMA exhibits potential as a therapeutic embolic agent due to its properties.
- Further research is warranted to optimize its use and mitigate risks.