Introduction Liquid embolic material (LEM) plays an essential role in the treatment of hemorrhagic stroke caused by arteriovenous malformation or dural arteriovenous fistula. However, currently available non-adhesive LEMs has the… Click to show full abstract
Introduction Liquid embolic material (LEM) plays an essential role in the treatment of hemorrhagic stroke caused by arteriovenous malformation or dural arteriovenous fistula. However, currently available non-adhesive LEMs has the problem of catheter entrapment, and also known to have a cytotoxic effect due to the organic solvents such as Dimethyl Sulfoxide (DMSO). The New Generation Liquid Embolic Material (NGLEM) is a clear liquid that immediately forms a solid hydrogel cast upon exposure to Ca2+ in the bloodstream, and organic solvents are not required. The performance of this new liquid embolic material was evaluated using an in vivo experimental model using rabbit. Methods Under general anesthesia, a renal artery of New Zealand rabbit (4.5–5.0 kg) was catheterized under fluoroscopy using a microcatheter, and NGLEM (Aqua Embolic System) was injected into the artery. Following factors were assessed; 1) the amount of LEM required for the complete occlusion, 2) injection speed, 3) duration of the injection, 4) radiopacity during the deployment and 5) incidence of catheter entrapment after the injection. Results 10 renal arteries in 10 rabbits were treated, and all arteries were completely occluded without technical complication. The injected materials immediately formed LEM cast in all vessels followed by the reflux over the microcatheter. All catheters were withdrawn without any sign of catheter entrapment. The NGLEM mixed with tantalum based (10 animals) contrasts medium showed sufficient radiopacity under fluoroscopy. With the injection speed of 0.02 ml/sec, the average volume required was 0.68 ml. Average time for the complete occlusion was 237 seconds. No increased thrombogenicity or vasospasm near the treated lesion was observed during the procedure. Conclusions NGLEM, which is a DMSO free, non-adhesive bio-polymer may be used as an embolic material for the treatment of hemorrhagic stroke caused by cerebrovascular diseases. Disclosures I. Yuki: 1; C; Research Grant: Institute for Clinical and Translational Science (ICTS) Pilot Award (NIH Director’s Transformative Research Award initiative), Research Grant Supported by the MEXT (Ministry of Education, Culture, Sports, Science and Technology), Government of Japan. K. Ohkawa: 1; C; Research Grant Supported by the MEXT (Ministry of Education, Culture, Sports, Science and Technology), Government of Japan. 2; C; N/A. 3; C; N/A. 4; C; N/A. 5; C; N/A. 6; C; N/A. F. Hsu: 1; C; Research Grant: Institute for Clinical and Translational Science (ICTS) Pilot Award. J. Xu: None. S. Li: None. S. Suzuki: 1; C; Research Grant: Institute for Clinical and Translational Science (ICTS) Pilot Award (NIH Director’s Transformative Research Award initiative).
               
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