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Title: Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep

Abstract

Purpose. The objective of this study was to investigate the feasibility, outcomes, and amount of small intestinal submucosa (SIS) material needed for embolization of jugular vein (JV) in a swine and sheep model. Our hypothesis was that SIS would cause vein occlusion. Materials and Methods. The external JVs (EJV) in swine (n = 6) and JVs in sheep (n = 6) were occluded with SIS fan-folded compressed strips. After percutaneous puncture of the peripheral portion of the EJV or JV, a TIPS set was used to exit their lumen centrally through the skin. The SIS strips were delivered into the isolated venous segment with a pull-through technique via a 10-Fr sheath. Follow-up venograms were done immediately after placement and at the time of sacrifice at 1 or 3 months. Gross examinations focused on the EJV or JV and their surrounding structures. Specimens were evaluated by histology. Results. SIS strip(s) placement was successful in all cases, with immediate vein occlusion seen in 23 of 24 veins (95.8%). All EJVs treated with two strips and all JVs treated with three or four strips remained closed on 1- and 3-month follow-up venograms. Two EJVs treated with one strip and one JV treated withmore » two strips were partially patent on venograms at 1 and 3 months. There has been one skin inflammatory reaction. Necropsies revealed excluded EJV or JV segments with SIS incorporation into the vein wall. Histology demonstrated various stages of SIS remodeling with fibrocytes, fibroblasts, endothelial cells, capillaries, and inflammatory cells. Conclusion. We conclude that EJV and JV ablation with SIS strips using percutaneous exit catheterization is feasible and effective in animal models. Further exploration of SIS as vein ablation material is recommended.« less

Authors:
; ; ; ; ; ; ; ; ; ;  [1]
  1. Oregon Health and Sciences University, Dotter Interventional Institute (United States)
Publication Date:
OSTI Identifier:
21090844
Resource Type:
Journal Article
Journal Name:
Cardiovascular and Interventional Radiology
Additional Journal Information:
Journal Volume: 30; Journal Issue: 4; Other Information: DOI: 10.1007/s00270-007-9070-1; Copyright (c) 2007 Springer Science+Business Media, LLC; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0174-1551
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABLATION; CAPILLARIES; FIBROBLASTS; HISTOLOGY; INFLAMMATION; SHEEP; SKIN; SWINE; VEINS

Citation Formats

Kim, Man Deuk, Hoppe, Hanno, Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu, Kaufman, John A., Uchida, Barry T., Correa, Luiz O., Timmermans, Hans A., Park, Won Kyu, Corless, Christopher L., Keller, Frederick S., and Roesch, Josef. Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep. United States: N. p., 2007. Web. doi:10.1007/S00270-007-9070-1.
Kim, Man Deuk, Hoppe, Hanno, Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu, Kaufman, John A., Uchida, Barry T., Correa, Luiz O., Timmermans, Hans A., Park, Won Kyu, Corless, Christopher L., Keller, Frederick S., & Roesch, Josef. Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep. United States. doi:10.1007/S00270-007-9070-1.
Kim, Man Deuk, Hoppe, Hanno, Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu, Kaufman, John A., Uchida, Barry T., Correa, Luiz O., Timmermans, Hans A., Park, Won Kyu, Corless, Christopher L., Keller, Frederick S., and Roesch, Josef. Sun . "Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep". United States. doi:10.1007/S00270-007-9070-1.
@article{osti_21090844,
title = {Percutaneous Vein Occlusion with Small Intestinal Submucosa: An Experimental Pilot Study in Swine and Sheep},
author = {Kim, Man Deuk and Hoppe, Hanno and Pavcnik, Dusan, E-mail: pavcnikd@ohsu.edu and Kaufman, John A. and Uchida, Barry T. and Correa, Luiz O. and Timmermans, Hans A. and Park, Won Kyu and Corless, Christopher L. and Keller, Frederick S. and Roesch, Josef},
abstractNote = {Purpose. The objective of this study was to investigate the feasibility, outcomes, and amount of small intestinal submucosa (SIS) material needed for embolization of jugular vein (JV) in a swine and sheep model. Our hypothesis was that SIS would cause vein occlusion. Materials and Methods. The external JVs (EJV) in swine (n = 6) and JVs in sheep (n = 6) were occluded with SIS fan-folded compressed strips. After percutaneous puncture of the peripheral portion of the EJV or JV, a TIPS set was used to exit their lumen centrally through the skin. The SIS strips were delivered into the isolated venous segment with a pull-through technique via a 10-Fr sheath. Follow-up venograms were done immediately after placement and at the time of sacrifice at 1 or 3 months. Gross examinations focused on the EJV or JV and their surrounding structures. Specimens were evaluated by histology. Results. SIS strip(s) placement was successful in all cases, with immediate vein occlusion seen in 23 of 24 veins (95.8%). All EJVs treated with two strips and all JVs treated with three or four strips remained closed on 1- and 3-month follow-up venograms. Two EJVs treated with one strip and one JV treated with two strips were partially patent on venograms at 1 and 3 months. There has been one skin inflammatory reaction. Necropsies revealed excluded EJV or JV segments with SIS incorporation into the vein wall. Histology demonstrated various stages of SIS remodeling with fibrocytes, fibroblasts, endothelial cells, capillaries, and inflammatory cells. Conclusion. We conclude that EJV and JV ablation with SIS strips using percutaneous exit catheterization is feasible and effective in animal models. Further exploration of SIS as vein ablation material is recommended.},
doi = {10.1007/S00270-007-9070-1},
journal = {Cardiovascular and Interventional Radiology},
issn = {0174-1551},
number = 4,
volume = 30,
place = {United States},
year = {2007},
month = {7}
}