13th Annual Global Embolization Symposium & Technologies
Purpose : To test the performance of a bioengineered gel embolic to current coils used today in an anticoagulated pig model of arterial embolization.
Material and Methods : Yorkshire pigs weighing 50-60kg were used and anticoagulated with IV heparin (ACT 250-500). Briefly, via carotid artery access under US guidance, a catheter was delivered to the pelvic arteries. On one side of the pelvis, coil embolization of the internal iliac artery was performed. On the other side, approximately 3 cc of the embolic material was injected. On sacrifice, embolized arteries were harvested and histology, microCT analysis and near-infrared imaging was performed. CBC, Chem-7 and coagulation tests were completed pre and post embolization. Post-embolization, blood samples were analyzed for activation of inflammatory markers such as acute phase reactants.
Results : Arteries embolized with multiple types of coils demonstrated persistent flow on DSA images. Arteries embolized with 3 cc of biomaterials achieved instantaneous hemostasis and complete embolization regardless of anticoagulation status. Injection of 1-2 cc of biomaterial to the arteries symbolized using coils was able to rescue and achieve instant hemostasis. In addition, injected biomaterial could be successfully retrieved using various 5-6 French catheters. Histology of the embolized arteries demonstrated complete filling of the artery; near infrared imaging of ICG mixed with biomaterial demonstrated absence of biomaterial in small vessels including capillaries. CBC and chemistry labs as well as inflammatory markers were not significantly different pre and post embolization (P<0.05). Scanning electron microscope images of the embolized arteries showed absence of recanalization of the biomaterial. MicroCT images demonstrated uniform filling of target vessels and absence of biomaterial in small vessels.
Conclusions : Gel embolic biomaterial outperforms coil technologies in every aspect tested including speed and ease of delivery and in achieving hemostasis despite anticoagulated state. Biomaterials can also be retrieved suggesting that temporary embolization could be possible.