Development of a new embolic material with superabsorbent polymer microsphere

高吸水性聚合物微球、丙烯酸钠和乙烯醇共聚物(SAP-MS)作为动脉栓塞剂的研究。精确标定了颗粒的直径以控制遮挡程度。评估微导管的通过能力。SAP-MS用无水酒精灭菌，并在真空瓶中制备，用于临床。同时评价了丙烯酸酯聚合物钠盐的临床应用。动物实验评价了兔肾的栓塞效果和组织病理学反应。随诊血管造影显示肾动脉完全闭塞。栓塞术后未见再通。动脉管腔被SAP-MS完全闭塞，扩张的血管直径大于动脉的原始直径。动脉壁及血管周围组织未见反应性改变。结果临床应用SAP-MS栓塞术治疗有肿瘤性病变的患者，在肝细胞癌中，无抗肿瘤药物的情况下获得了坏死的效果。术前栓塞术导致侵入性较小的手术干预。肾细胞癌的坏死灶效果不理想。转移性骨肿瘤在控制局部疼痛方面效果良好，无并发症，动静脉畸形经SAP-MS栓塞术控制良好，无并发症，但合并动静脉瘘的病变未经其他材料处理。

EVALUATION OF SUPER ABSORBENT POLYMERThe super absorbent polymer microsphere, sodium acrylate and vinyl alcohol copolymer (SAP-MS) was investigated as an arterial embolic material. The diameter of the particles was exactly calibrated to control the occlusion level. Passage ability through microcatheters was estimated. SAP-MS were sterilized by absolute alcohol and prepared in the vacuum vial for clinical purpose. Acrylate acid polymer sodium salt was simultaneously evaluated for clinical purposes.ANIMAL STUDIESAnimal studies were done to evalute the embolic effects and histopathologic reaction by the embolization of rabbits kidneys. The follow-up angiographies indicated the total occlusion of embolized renal artery. No recanalization was found after the embolization. The arterial lumen was completely occluded by the SAP-MS which expanded larger than the original diameter of the artery. No reactive changes were found in the arterial wall and perivascular tissue. Extensive fibrosis in the whole renal tissue and calcification mainly in the cortex were found.CLINICAL RESULTSPatients with neoplastic lesions were treated by embolotherapy with SAP-MS.In hepatocellular carcionoma, necrotic effects without anti-neoplastic agent were obtained. Preoperative embolization resulted in less invasive surgical interventions. Unsatisfactory necrotic effects was archived in cases of renal cell carcinoma. Metastatic bone tumors were well treated in control of local pain without complications.Arteriovenous malformations were well controlled by embolization using SAP-MS without any complication, however, the lesions coexisting AV fistula were not managed without combination use of other materials.