Assessment of Embolic Occlusion of Porcine Kidneys following different Embolic Techniques

Sunday, March 5, 2023

4:12 PM – 4:21 PM

Location: Phoenix Convention Center, 222C

Abstract Speaker(s)

CB

Camilo Barragan, MD MSc

VIR Clinical Fellow
UHN/MSH

Disclosure information not submitted.

Author/Co-author(s)

SM

Sebastian Mafeld, MBBS FRCR (he/him/his)

Interventional Radiologist
University Health Network
Dheeraj Rajan, MD FRCPC FSIR

Professor
University of Toronto

Disclosure(s):

Dheeraj Rajan, MD FRCPC FSIR: Baylis Medical Technologies: Consultant (Ongoing); Becton Dickenson: Consultant (Ongoing); Medtronic Inc: Consultant (Ongoing); WL Gore & Associates: Consultant (Ongoing)

Purpose:

To determine if embolic delivery technique (pulsed vs continuous) influences the level and completeness of embolization with particles

Materials and Methods: Animal Use Protocol approval was obtained. Three Swine Pigs between 35 to 40 kg were embolized using radiopaque microspheres 70 - 150 microns suspended in the recommended volume of contrast (Lumi beads). Bilateral kidneys were embolized; one side with continuous injection technique (1cc/second continuously) and the contralateral kidney with intermittent pulsed injection (1 cc/sec followed by a one-second pause) until stasis was obtained in the main renal artery. Each pig acted as their own control for comparison of technique. Immediately following embolization, both kidneys were harvested for imaging evaluation. Pixel quantification to assess embolization efficiency at 5 and 10 cm from surface was performed with micro-CT (resolution 100um). Kidney sizes were measured prior to embolization and volume of embolic injected per kidney was also recorded

Results:

All embolization procedures were technically successful. There was a larger amount of embolic agent quantified at 5 and 10 cm from surface using continuous injection vs pulsed injection based on reconstructions from datasets obtained from micro-CT imaging. Average kidney volume for pulsed technique was 73ml, for continuous it was 66ml. Average volume of embolic injected with each technique was 11.4cc for pulsed and 14cc for continuous. Mean embolic/kidney volume ratio was 0.15 for pulsed vs 0.21 for continuous technique (39% difference). Table. Percentage of embolic agent to kidney parenchyma; c = continuous injection; p = pulsed injection

Conclusion: Continuous injection technique for embolization procedures results in higher concentration of embolic agent inside the porcine distal microvasculature compared to traditional pulsed injection technique suggesting that embolic technique may influence efficacy of embolization