title: Forcible intraarterial injection of a nonadhesive liquid embolic agent under microballoon occlusion: experimental study in swine liver.
abstract: OBJECTIVE
  To evaluate the feasibility and effectiveness of transcatheter embolization by forcible intraarterial injection of a mixture of ethylene vinyl alcohol copolymer (EVAL) and ethanol under microballoon occlusion compared with conventional transcatheter arterial embolization methods in nontumoral swine liver.
  
  
  METHODS
  Nine swine were divided into three groups: embolization with EVAL/ethanol mixture (EVAL group, n = 5), with ethiodized oil (ethiodized oil group, n = 2), and with microspheres (microspheres group, n = 2). Embolization was performed at the subsegmental hepatic artery. The EVAL/ethanol mixture was injected forcibly through a microcatheter with a balloon, which was inflated to prevent backflow of the mixture during the injection. Ethiodized oil or microspheres were injected into the artery using a microcatheter without balloon occlusion. Two animals of the EVAL group were euthanized immediately after embolization, and the distribution of EVAL was assessed microscopically. The remaining seven animals were euthanized 4 weeks after embolization, and the histopathologic changes were assessed.
  
  
  RESULTS
  All procedures were technically successful. EVAL occupied > 80% of the hepatic arterial, portal venous, and sinusoidal lumens after embolization. Ischemic coagulation necrosis was observed 4 weeks after embolization in the EVAL group. Parenchymal necrosis was not observed in the ethiodized oil and microspheres groups.
  
  
  CONCLUSIONS
  Transcatheter embolization by forcible intraarterial injection of an EVAL/ethanol mixture under microballoon occlusion was feasible and achieved the simultaneous embolization of hepatic artery, portal vein, and sinusoids in swine liver, resulting in complete necrosis of the segment that received embolization.
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan. Electronic address: ogi@bc.iij4u.or.jp.
authors: Takahiro
authors: T
authors: Ogi
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Osamu
authors: O
authors: Matsui
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Junichiro
authors: J
authors: Sanada
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Tetsuya
authors: T
authors: Minami
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Kazuto
authors: K
authors: Kozaka
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Dai
authors: D
authors: Inoue
authors: Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
authors: Toshifumi
authors: T
authors: Gabata
mesh_terms: D000818:Animals; D021721:Balloon Occlusion / Q000295:instrumentation; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D000431:Ethanol / Q000008:administration & dosage*; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D006499:Hepatic Artery / Q000000981:diagnostic imaging; D007269:Injections, Intra-Arterial; D008099:Liver / Q000098:blood supply* / Q000473:pathology; D008863:Microspheres; D008904:Miniaturization; D023421:Models, Animal; D009336:Necrosis; D011145:Polyvinyls / Q000008:administration & dosage*; D011169:Portal Vein / Q000000981:diagnostic imaging; D015641:Radiography, Interventional; D013552:Swine; D013997:Time Factors
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer; D000431:Ethanol; D004998:Ethiodized Oil