Effect of renal embolization with trisacryl and PAVc

Abstract

Objectives: Evaluate the degree of vascular occlusion, vascular recanalization, and necrosis of the vascular wall caused by polyvinyl alcohol-covered polyvinyl acetate (PVAc) particles compared to trisacryl particles after renal embolization.

Methods: Seventy-nine female albino New Zealand rabbits underwent arterial catheterization of the right kidney. Thirty-three animals were embolized with trisacryl particles, thirty-one with PVAc particles, and fifteen were kept as controls. Four animals were excluded (three trisacryl and one PVAc) due to early death. Five subgroups of six animals were created. The animals in the different groups were sacrificed either 48 hours, 5 days, 10 days, 30 days, or 90 days after embolization. The control group was divided into subgroups of three animals each and kept for the same periods of time. The kidneys were dyed with hematoxylin-eosin and Masson's trichrome and then examined using optical microscopy.

Results: There were significant differences in the degree of vascular occlusion caused by the trisacryl and the PVAc particles between the five-day and the ten-day groups. Additional differences were noted between the five-day and 48-hour groups in regard to the amount of necrosis. For both findings, the PVAc group members showed adequate tissue reaction (ischemia and volumetric reduction) and less recanalization than those treated with trisacryl.

Conclusion: The use of PVAc as an embolization material exhibited an adequate tissue reaction (ischemia and volumetric reduction), more expressive vascular occlusion and necrosis, and less recanalization than the trisacryl material.

Keywords: Interventional radiology; Kidney; Microspheres; Particles; Therapeutic embolization.

Figure 1

Renal angiography - Arterial stage and parenchymal before and after embolization

Figure 2

Macroscopic photographs of the right (embolized) kidney and the contralateral (control) kidney immediately after sacrificing the animal (these kidneys are from an animal in the 90-day post-embolization PVAc group)

Figure 3

Deformed trisacryl particles and spaces left by them in the vessel lumen

Figure 4

PVA particles retain their original shape and occupy all of the space within the vessel