A reexamination of the angiotoxicity of superselective injection of DMSO in the swine rete embolization model.
OBJECTIVE
There are a variety of embolization applications for non-adhesive, liquid agents. We reevaluated the potential microvascular angiotoxicity of superselective infusions of dimethyl sulfoxide (DMSO) using very long infusion rates in a previously described animal model.


METHODS
Twenty-six swine underwent percutaneous femoral puncture for superselective catheterization of the artery of the rete while being continuously monitored for ECG and intraarterial pressure. Two volumes (0.5 or 0.8 mL) and three durations (30, 60, and 90 seconds) of superselective infusion of DMSO were used to evaluate the effect of a single-dose rate within an ipsilateral rete. Contralateral control infusions of normal saline were also administered. Acute hemodynamic and angiographic outcomes were assessed. After recovery, follow-up angiography and sacrifice were performed at either 10 or 28 days. Brains and retia were harvested for gross and microscopic histopathologic evaluation.


RESULTS
No significant hemodynamic alterations occurred acutely. Twenty-three of the 24 infused retia showed variable acute vasospasm that typically was mild to moderate in severity and transient (10 to 20 minutes). Follow-up angiography at sacrifice always showed normal retial arterial anatomy. No adverse clinical sequelae were noted. Gross inspection of brains showed no evidence of infarction or subarachnoid hemorrhage. Microscopic histopathologic examination of retia showed mostly nonspecific changes in both exposed and control samples. Possible causal histotoxicity was seen in four retia (three of four exposed to higher dose rates), in which involvement was limited to one to three retial arteries.


CONCLUSIONS
Lower total dose and dose rates of superselective infusion of DMSO into the retial microarterial network resulted in substantially less angiotoxicity than that found in a previous study, as defined by clinical, angiographic, gross, and histopathologic criteria.
Chaloupka
J C
JC
Department of Diagnostic Radiology, Yale University School of Medicine, USA.
Huddle
D C
DC
Alderman
J
J
Fink
S
S
Hammond
R
R
Vinters
H V
HV
D015901:Angiography, Digital Subtraction; D000818:Animals; D001158:Arteries / Q000187:drug effects / Q000473:pathology; D001794:Blood Pressure / Q000502:physiology; D002406:Catheterization, Peripheral; D002536:Cerebral Arteries / Q000187:drug effects / Q000473:pathology; D002544:Cerebral Infarction / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage / Q000009:adverse effects*; D004195:Disease Models, Animal; D004562:Electrocardiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005263:Femoral Artery; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D007261:Infusions, Intra-Arterial; D002546:Ischemic Attack, Transient / Q000139:chemically induced / Q000473:pathology; D008833:Microcirculation / Q000187:drug effects* / Q000473:pathology; D010614:Pharynx / Q000098:blood supply; D012965:Sodium Chloride; D012997:Solvents / Q000008:administration & dosage / Q000009:adverse effects*; D013345:Subarachnoid Hemorrhage / Q000473:pathology; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome; D014661:Vasoconstriction
D012997:Solvents; D012965:Sodium Chloride; D004121:Dimethyl Sulfoxide