Experimental study on acute ischemic small bowel changes induced by superselective embolization of superior mesenteric artery branches with N-butyl cyanoacrylate.
OBJECTIVE
To evaluate the degree of ischemic changes of the small bowel after superselective embolization of superior mesenteric artery (SMA) branches at the vasa recta level with N-butyl cyanoacrylate (NBCA) in dogs.


METHODS
In six dogs, superselective embolization was performed with NBCA in five isolated branches of the SMA at the vasa recta level. All dogs were sacrificed 24 hours after embolization. According to the extent of the NBCA mixtures on radiographs of the specimen, embolized segments were divided into group A (embolization of three or fewer vasa recta) or group B (embolization of four or more vasa recta). Histologic evaluation of the mucosal, submucosal, and muscle layers of the embolized segments was performed by a pathologist.


RESULTS
In group A (n=15), histologic findings were normal in seven segments (47%). Mild ischemic changes were noted in the mucosal layer in eight segments, the submucosal layer in four segments, and the muscle layer in one segment. In group B (n=15), ischemic changes were noted in the mucosal layer in all 15 segments, the submucosal layer in 14 segments, and the muscle layer in 10 segments. The difference in ischemic damage between groups A and B was statistically significant.


CONCLUSIONS
Superselective embolization involving three or fewer vasa recta of the SMA was relatively tolerable, and embolization involving four or more vasa recta carried an increased risk of substantial ischemic bowel damage. Further studies are necessary to determine the clinical implications of our findings in human subjects.
Jae
Hwan Jun
HJ
Department of Radiology, Seoul National University Hospital, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.
Chung
Jin Wook
JW
Kim
Hyo-Cheol
HC
So
Young Ho
YH
Lim
Hyung Guhn
HG
Lee
Whal
W
Kim
Byoung-Kwon
BK
Park
Jae Hyung
JH
D000818:Animals; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods*; D007421:Intestine, Small / Q000098:blood supply* / Q000000981:diagnostic imaging; D007511:Ischemia / Q000473:pathology*; D017538:Mesenteric Artery, Superior; D011859:Radiography; D018709:Statistics, Nonparametric