Embolic Agent (embolic + agent)

Distribution by Scientific Domains

Selected Abstracts

Successful angiographic embolization of recurrent elbow and knee joint bleeds in seven patients with severe haemophilia

HAEMOPHILIA, Issue 1 2009
Summary., In haemophilic joints with high-grade arthropathy, bleeds occur that do not respond to replacement therapy of the deficient coagulation factor. The reason may be pathologically reactive angiogenesis in chronic synovitis. Seven patients with severe haemophilia A or haemophilia B experienced recurrent massive bleeds of one elbow joint or knee joint in the absence of trauma. After initial application of factor VIII or IX (fVIII/fIX; 50 IU kg,1 bodyweight), there was only slow and never complete relief of symptoms. Despite intensive secondary prophylaxis maintaining the plasma level of factor concentrate at minimum 50%, new massive bleeds at the same location occurred. Vascular bleeding was suspected. Angiography of the arteries was performed via the femoral artery. Vessels identified as potential bleeding sources were embolized with embolization fluid (ONYX) in eight joints (six elbow and two knee joints). Under low-dose prophylactic treatment (15 IU fVIII or fIX per kg bodyweight for three times per week), no recurrent severe bleed unresponsive to coagulation factor replacement occurred after a mean observation time of 16 months after embolization. The consumption of factor concentrate decreased to one-third of the amount consumed before embolization. In conclusion, angiographic embolization with a non-adhesive liquid embolic agent might be considered as a promising therapeutic and coagulation factor saving option in joint bleeds not responding to replacement of coagulation factor to normal levels. [source]

Cisplatin-conjugated Gelpart: initial study in vitro

Shinichi Ohta
Aim:, In Japan, Gelpart (Nippon Kayaku, Tokyo, Japan) is commercially available as an embolic agent made of gelatin for hepatocellular carcinoma. The object of this study was to develop cisplatin-conjugated Gelpart, confirm its bonding capability and confirm cisplatin-release from it in vitro. Methods:, Gelpart (80 mg) were immersed in 50 mL of the cisplatin solution (0.3 mg/mL) at 38C for 1 hour to allow conjugation to cisplatin. Half of them were washed with double distilled water and centrifuged seven times to remove the uncombined cisplatin from Gelpart. Five mg of washed Gelpart and 5 mg unwashed Gelpart were freeze-dried and the platinum concentrations in these Gelpart were analyzed. In an in vitro release test, 30 mg of each cisplatin-conjugated Gelpart were placed in 10 mL of phosphate buffered salts (PBS) containing 0.01 wt.% Tween 80 and the system was shaken reciprocally at 72 strokes/min at 38C. At different time intervals (1, 3, 6, 12 and 24 hours), 5 mL of the supernatant was pipetted out and immediately after that the same volume of PBS was added. The platinum concentration of the solutions sampled was measured and the release rate from cisplatin-conjugated Gelpart was calculated. Results:, The platinum concentrations (g/g) of unwashed Gelpart and washed Gelpart were, respectively, 9563.5 101.1 and 6396.5 14.8. The release rates (%) from unwashed Gelpart and from washed Gelpart were, respectively, 43.1, 56.3, 56.5, 58.5, 60.9 and 5.8, 6.7, 8.5, 11.0, 12.0. Conclusion:, Gelpart had a bonding capability to cisplatin and an ability of sustained release from it. Cisplatin-conjugated Gelpart might become a simple embolic agent with drug delivery systems. [source]

Cyanoacrylate embolization of endoleaks after abdominal aortic aneurysm repair

Timothy Buckenham
Abstract Introduction:, Type II endoleaks occur in up to a fifth of endoluminal repairs for abdominal aortic aneurysms and are commonly treated when aortic sac expansion can be demonstrated. Technical failure is common when catheter-guided particulates or coil embolic agents are used. Presented here is a feasibility study using catheter-directed N-butyl-2-cyanoacrylate (Histoacryl, Braun, Tuttlingen, Germany) embolotherapy. Method:, A retrospective review of the case notes of patients undergoing embolization procedures for type II endoleaks with expanding sacs was performed from this centre's cohort of endoluminal aortic repair patients under surveillance. Data on patients with type II endoleaks who were treated with either or both cyanoacrylate and coil embolization were extracted. The outcomes were then compared. Results:, In total, five cases were identified, and four of these cases had both coil and glue embolization. Technical success was defined as endoleak closure proven on follow-up computed tomographic imaging. Technical success was achieved in all four patients treated with intra-sac cyanoacrylate. One case treated initially with coil embolization was successful. All patients had a computed tomographic scan at 3 months. One minor complication occurred that resolved without treatment. Discussion:, Type II endoleaks after EVAR with expanding sacs require treatment. Percutaneous catheter-directed cyanoacrylate embolization offers an alternative to coil or particulate embolization and, in this series, was found to be more likely to result in endoleak closure. [source]