Trisacryl gelatin microspheres for therapeutic embolization, II: preliminary clinical evaluation in tumors and arteriovenous malformations.

PURPOSE To evaluate an embolic agent that is precisely calibrated, perfectly spherical in shape, and soft but nonresorbable for use in the embolization of vascular disease of the head, neck, and spine in humans. METHODS We used supple, hydrophilic, and calibrated trisacryl gelatin microspheres 200, 400, 600, 800 and 1000 microns in diameter for superselective embolization in 105 patients (27 tumors, 14 facial arteriovenous malformations [AVMs], 37 spinal cord AVMs, 21 cerebral AVMs, and 6 miscellaneous diseases). We used particles in 200 to 600 microns in diameter for tumors and for facial AVMs, particles 400 to 600 microns in diameter for spinal cord AVMs, and particles over 1000 micros in diameter for cerebral AVMs. RESULTS Delivery of the embolic material was easy: microspheres did not aggregate and catheters did not become obstructed by particles. It was possible to control the embolization through precise accounting of the amount of microspheres and matching of the particle size to the size of the pathologic vascular network. CONCLUSION The microspheres are easy to use and allow precise control of the embolization procedure. Their physical characteristics make them a safe embolic agent.

[1]  S. Nishio,et al.  Peritumoral brain edema in meningiomas--influence of vascular supply on its development. , 1992, Neurosurgery.

[2]  J. Hodes,et al.  Calibrated sphere embolization of craniofacial tumours and arteriovenous malformations , 1991 .

[3]  V. Radhakrishnan,et al.  Hydrolysed microspheres from cross-linked polymethyl methacrylate (Hydrogel). A new embolic material for interventional neuroradiology. , 1991, Journal of neuroradiology. Journal de neuroradiologie.

[4]  J. Benoit,et al.  In vitro and in vivo degradation of poly(D,L lactide/glycolide) type microspheres made by solvent evaporation method. , 1989, Biomaterials.

[5]  I. Repa,et al.  Mortalities associated with use of a commercial suspension of polyvinyl alcohol. , 1989, Radiology.

[6]  E. Russell,et al.  Direct catheter redirection of a symptomatic errant intracranial Silastic sphere embolus. , 1987, Radiology.

[7]  J. Kálal,et al.  Hydrogels in endovascular embolization. III. Radiopaque spherical particles, their preparation and properties. , 1987, Biomaterials.

[8]  J. Benoit,et al.  5-Fluorouracil:carnauba wax microspheres for chemoembolization: an in vitro evaluation. , 1986, Journal of pharmaceutical sciences.

[9]  A. Fox,et al.  Dextran microsphere embolization: experimental and clinical experience with radiologic-pathologic correlation. Work in progress. , 1986, Radiology.

[10]  C. Fournier,et al.  Uptake enhancement of platinum in the dog kidney by microencapsulation of cisplatin and local injection. , 1986, Anticancer research.

[11]  R. Cosgrove,et al.  Spinal arteriovenous malformations: advances in therapeutic embolization. , 1986, Radiology.

[12]  Y. Morimoto,et al.  Biodegradable mitomycin C microspheres given intra‐arterially for inoperable hepatic cancer. With particular reference to a comparison with continuous infusion of mitomycin C and 5‐fluorouracil , 1985, Cancer.

[13]  G. Forbes,et al.  Polyvinyl alcohol sponge for embolotherapy: particle size and morphology. , 1985, AJNR. American journal of neuroradiology.

[14]  S. Reuter,et al.  Collateral circulation following repeated distal embolization of the hepatic artery in pigs. , 1984, Investigative radiology.

[15]  M. Iio,et al.  Gelatin gel beads as an embolic agent. , 1983, Radiation medicine.

[16]  J. Anderson,et al.  Partial splenic embolization using polyvinyl alcohol foam, dextran, polystyrene, or silicone. An experimental study in dogs. , 1982, Radiology.

[17]  F. Puisieux,et al.  [A study in dogs of micropellets for use in angiographic therapeutic procedures (author's transl)]. , 1981, Journal de radiologie.

[18]  Tetsuro Kato,et al.  Arterial chemoembolization with mitomycin C microcapsules in the treatment of primary or secondary carcinoma of the kidney, liver, bone and intrapelvic organs , 1981, Cancer.

[19]  S. Nakasu,et al.  Facial nerve palsy following therapeutic embolization. , 1980, Surgical neurology.

[20]  P. Lasjaunias.  Nasopharyngeal angiofibromas: hazards of embolization. , 1980, Radiology.

[21]  F. Puisieux,et al.  Wax microemboli tailored for therapeutic embolization. , 1980, AJR. American journal of roentgenology.

[22]  C. Kerber,et al.  Polyvinyl alcohol foam: prepackaged emboli for therapeutic embolization. , 1978, AJR. American journal of roentgenology.

[23]  E. Boschetti,et al.  Preparation of hydrophilic copolymers in bead form as carriers in affinity chromatography , 1978 .

[24]  Forsberg Jo.  Transient blood flow reduction induced by intra-arterial injection of degradable starch microspheres. Experiments on rats. , 1978 .

[25]  J. O. Forsberg.  Transient blood flow reduction induced by intra-arterial injection of degradable starch microspheres. Experiments on rats. , 1978, Acta chirurgica Scandinavica.

[26]  J. Bories,et al.  Superselective Arteriography of the Branches of the External Carotid Artery , 1975 .

[27]  C. Benton,et al.  Treatment of facial hemangioma by intravascular embolization with silicone spheres. Case report. , 1972, Plastic and reconstructive surgery.

[28]  A. Luessenhop,et al.  Artificial embolization of cerebral arteries. Report of use in a case of arteriovenous malformation. , 1960, Journal of the American Medical Association.

[29]  K. Haeger.  Studies of the coronary circulation. I. The surgical anatomy of the right coronary artery of the dog and the effects of acute ligation. , 1959, The Journal of thoracic surgery.

[30]  Studies on the coronary circulation , 1947 .