Pure ethiodized oil-based transcatheter ablative therapy in normal rabbit kidneys and kidneys inoculated with VX-2 carcinoma.
OBJECTIVE
To evaluate the efficacy of ablation with selective arterial injection of pure ethiodized oil followed by arterial occlusion with 9:1 ethanol-Ethiodol mixture (EEM) and coil placement in normal rabbit kidneys and kidneys inoculated with VX-2 carcinoma.


METHODS
All experiments were conducted with Animal Care and Use Committee approval. In six rabbits (group 1), one kidney was embolized with pure Ethiodol until capillary stasis, followed by injection of 9:1 EEM until arterial stasis and then coil placement into the main renal artery. In 12 other rabbits, one kidney was inoculated with VX-2 tumor. Ethiodol and EEM embolization and coil placement followed 7 days later (group 2, n = 6) or 11-14 days later (group 3, n = 6). Kidneys were evaluated (angiography, computed tomography, macro- and microscopy) 7 days after treatment.


RESULTS
Capillary stasis was achieved in groups 1, 2, and 3 with (mean ± standard deviation) 0.47 ± 0.03, 0.53 ± 0.02, and 0.56 ± 0.04 ml of pure Ethiodol, followed by 0.47 ± 0.05, 0.42 ± 0.03, and 0.38 ± 0.04 ml of EEM, respectively, which caused complete arterial occlusion in 17 of 18 kidneys. In group 1, all but one kidney showed at least 95% generalized coagulative necrosis. In group 2, all six kidneys exhibited 100% coagulative necrosis, with no viable tumor present. In group 3, 100% coagulative necrosis was present in all kidneys, with a small viable tumor in one.


CONCLUSIONS
In the rabbit, selective arterial injection of pure Ethiodol can cause complete renal parenchyma and tumor ablation when it is followed by prompt, contiguous, and permanent occlusion of the arterial compartment.
Section of Interventional Radiology, Division of Diagnostic Imaging, Department of Diagnostic Radiology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Unit 325, Houston, TX 77030, USA. akonya@mdanderson.org
András
A
Kónya
L Clifton
LC
Stephens
Kenneth C
KC
Wright
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002406:Catheterization, Peripheral; D016461:Chemoembolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage*; D004998:Ethiodized Oil / Q000008:administration & dosage*; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007680:Kidney Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D011817:Rabbits; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging
D000970:Antineoplastic Agents; D000431:Ethanol; D004998:Ethiodized Oil