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Title: Biocompatibility, Inflammatory Response, and Recannalization Characteristics of Nonradioactive Resin Microspheres: Histological Findings

Abstract

Intra-arterial radiotherapy with yttrium-90 microspheres (radioembolization) is a therapeutic procedure exclusively applied to the liver that allows the direct delivery of high-dose radiation to liver tumors, by means of endovascular catheters, selectively placed within the tumor vasculature. The aim of the study was to describe the distribution of spheres within the precapillaries, inflammatory response, and recannalization characteristics after embolization with nonradioactive resin microspheres in the kidney and liver. We performed a partial embolization of the liver and kidney vessels in nine white pigs. The left renal and left hepatic arteries were catheterized and filled with nonradioactive resin microspheres. Embolization was defined as the initiation of near-stasis of blood flow, rather than total occlusion of the vessels. The hepatic circulation was not isolated so that the effects of reflux of microspheres into stomach could be observed. Animals were sacrificed at 48 h, 4 weeks, and 8 weeks, and tissue samples from the kidney, liver, lung, and stomach evaluated. Microscopic evaluation revealed clusters of 10-30 microspheres (15-30 {mu}m in diameter) in the small vessels of the kidney (the arciform arteries, vasa recti, and glomerular afferent vessels) and liver. Aggregates were associated with focal ischemia and mild vascular wall damage. Occlusion of themore » small vessels was associated with a mild perivascular inflammatory reaction. After filling of the left hepatic artery with microspheres, there was some evidence of arteriovenous shunting into the lungs, and one case of cholecystitis and one case of marked gastritis and ulceration at the site of arterial occlusion due to the presence of clusters of microspheres. Beyond 48 h, microspheres were progressively integrated into the vascular wall by phagocytosis and the lumen recannalized. Eight-week evaluation found that the perivascular inflammatory reaction was mild. Liver cell damage, bile duct injury, and portal space fibrosis were not observed. In conclusion, resin microspheres (15-30 {mu}m diameter) trigger virtually no inflammatory response in target tissues (liver and kidney). Clusters rather than individual microspheres were associated with a mild to moderate perivascular inflammatory reaction. There was no evidence of either a prolonged inflammatory reaction or fibrosis in the liver parenchyma following recannalization.« less

Authors:
 [1];  [2]; ; ; ;  [1];  [3];  [2]
  1. Clinica Universitaria de Navarra, Universidad de Navarra, Department of Radiology (Spain)
  2. Universidad de Zaragoza, Department of Histology, School of Veterinary (Spain)
  3. Clinica Universitaria de Navarra, Universidad de Navarra, Department of Internal Medicine (Liver Unit) (Spain)
Publication Date:
OSTI Identifier:
21428487
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 32; Journal Issue: 4; Other Information: DOI: 10.1007/s00270-009-9592-9; Copyright (c) 2009 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BILIARY TRACT; INFLAMMATION; ISCHEMIA; KIDNEYS; LIVER; LIVER CELLS; MICROSPHERES; NEOPLASMS; RADIOTHERAPY; RESINS; SWINE; YTTRIUM 90; ANEMIAS; ANIMAL CELLS; ANIMALS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BLOOD VESSELS; BODY; CARDIOVASCULAR DISEASES; CARDIOVASCULAR SYSTEM; DAYS LIVING RADIOISOTOPES; DIGESTIVE SYSTEM; DISEASES; DOMESTIC ANIMALS; GLANDS; HEMIC DISEASES; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MAMMALS; MEDICINE; NUCLEAR MEDICINE; NUCLEI; ODD-ODD NUCLEI; ORGANIC COMPOUNDS; ORGANIC POLYMERS; ORGANS; PATHOLOGICAL CHANGES; PETROCHEMICALS; PETROLEUM PRODUCTS; POLYMERS; RADIOISOTOPES; RADIOLOGY; SOMATIC CELLS; SYMPTOMS; THERAPY; VASCULAR DISEASES; VERTEBRATES; YTTRIUM ISOTOPES

Citation Formats

Bilbao, Jose I., E-mail: Jibilbao@unav.e, Martino, Alba de, Luis, Esther de, Diaz-Dorronsoro, Lourdes, Alonso-Burgos, Alberto, Martinez de la Cuesta, Antonio, Sangro, Bruno, and Garcia de Jalon, Jose A.. Biocompatibility, Inflammatory Response, and Recannalization Characteristics of Nonradioactive Resin Microspheres: Histological Findings. United States: N. p., 2009. Web. doi:10.1007/S00270-009-9592-9.
Bilbao, Jose I., E-mail: Jibilbao@unav.e, Martino, Alba de, Luis, Esther de, Diaz-Dorronsoro, Lourdes, Alonso-Burgos, Alberto, Martinez de la Cuesta, Antonio, Sangro, Bruno, & Garcia de Jalon, Jose A.. Biocompatibility, Inflammatory Response, and Recannalization Characteristics of Nonradioactive Resin Microspheres: Histological Findings. United States. doi:10.1007/S00270-009-9592-9.
Bilbao, Jose I., E-mail: Jibilbao@unav.e, Martino, Alba de, Luis, Esther de, Diaz-Dorronsoro, Lourdes, Alonso-Burgos, Alberto, Martinez de la Cuesta, Antonio, Sangro, Bruno, and Garcia de Jalon, Jose A.. Wed . "Biocompatibility, Inflammatory Response, and Recannalization Characteristics of Nonradioactive Resin Microspheres: Histological Findings". United States. doi:10.1007/S00270-009-9592-9.
@article{osti_21428487,
title = {Biocompatibility, Inflammatory Response, and Recannalization Characteristics of Nonradioactive Resin Microspheres: Histological Findings},
author = {Bilbao, Jose I., E-mail: Jibilbao@unav.e and Martino, Alba de and Luis, Esther de and Diaz-Dorronsoro, Lourdes and Alonso-Burgos, Alberto and Martinez de la Cuesta, Antonio and Sangro, Bruno and Garcia de Jalon, Jose A.},
abstractNote = {Intra-arterial radiotherapy with yttrium-90 microspheres (radioembolization) is a therapeutic procedure exclusively applied to the liver that allows the direct delivery of high-dose radiation to liver tumors, by means of endovascular catheters, selectively placed within the tumor vasculature. The aim of the study was to describe the distribution of spheres within the precapillaries, inflammatory response, and recannalization characteristics after embolization with nonradioactive resin microspheres in the kidney and liver. We performed a partial embolization of the liver and kidney vessels in nine white pigs. The left renal and left hepatic arteries were catheterized and filled with nonradioactive resin microspheres. Embolization was defined as the initiation of near-stasis of blood flow, rather than total occlusion of the vessels. The hepatic circulation was not isolated so that the effects of reflux of microspheres into stomach could be observed. Animals were sacrificed at 48 h, 4 weeks, and 8 weeks, and tissue samples from the kidney, liver, lung, and stomach evaluated. Microscopic evaluation revealed clusters of 10-30 microspheres (15-30 {mu}m in diameter) in the small vessels of the kidney (the arciform arteries, vasa recti, and glomerular afferent vessels) and liver. Aggregates were associated with focal ischemia and mild vascular wall damage. Occlusion of the small vessels was associated with a mild perivascular inflammatory reaction. After filling of the left hepatic artery with microspheres, there was some evidence of arteriovenous shunting into the lungs, and one case of cholecystitis and one case of marked gastritis and ulceration at the site of arterial occlusion due to the presence of clusters of microspheres. Beyond 48 h, microspheres were progressively integrated into the vascular wall by phagocytosis and the lumen recannalized. Eight-week evaluation found that the perivascular inflammatory reaction was mild. Liver cell damage, bile duct injury, and portal space fibrosis were not observed. In conclusion, resin microspheres (15-30 {mu}m diameter) trigger virtually no inflammatory response in target tissues (liver and kidney). Clusters rather than individual microspheres were associated with a mild to moderate perivascular inflammatory reaction. There was no evidence of either a prolonged inflammatory reaction or fibrosis in the liver parenchyma following recannalization.},
doi = {10.1007/S00270-009-9592-9},
journal = {Cardiovascular and Interventional Radiology},
number = 4,
volume = 32,
place = {United States},
year = {Wed Jul 15 00:00:00 EDT 2009},
month = {Wed Jul 15 00:00:00 EDT 2009}
}