A new liquid embolic material for transcatheter hepatic arterial embolization

目的：评价一种新型液体栓塞材料“玛瑙”治疗肝脏肿瘤的可行性。材料和方法：“Onyx”是6%（w/v）乙烯-乙烯醇聚合物溶解在无水二甲亚砜（DMSO）中与28%（w/v）钽粉的混合物。除了6%的玛瑙外，我们还尝试了4%，2%和1%的溶液，通过调整DMSO的量来制备。我们使用15只经皮注射VX2肿瘤细胞造成肝脏肿瘤的大白兔。4组，每组3只兔，分别用6%、4%、2%和1%的玛玛石栓塞肝动脉，3只兔单独注射DMSO。注射在肝固有动脉分叉的近端进行，随后进行腹腔动脉造影。死后，用软组织x线摄影检查肝脏，并用显微镜检查肝脏组织切片。结果：6%、4%、2%玛瑙的右、左肝动脉栓塞物通过的最大动脉分支点分别为11个、15个、16个，1%玛瑙无法测量。肿瘤区6%、4%、2%、1%玛石的最小动脉直径分别为40μm、35μm、20μm、10μm，非肿瘤区35μm、5μm、5μm、5μm。结论：本研究提示玛瑙治疗肝脏肿瘤是可行的。

Purpose:To evaluate the feasibility of a new liquid embolic material, 'Onyx', for treating liver tumor.Material and Methods:'Onyx' is a mixture of 6%(w/v) ethylene-vinyl alcohol polymer dissolved in anhydrous dimethyl sulfoxide (DMSO) with 28%(w/v) tantalum powder. In addition to 6% Onyx, we also tried 4%, 2% and 1% solutions, prepared by adjusting the amount of DMSO. We used 15 white rabbits with liver tumors created by percutaneous injection of VX2 tumor cells. In 4 groups with 3 rabbits in each, the liver arteries were embolized with 6%, 4%, 2% and 1% Onyx, respectively, and in 3 rabbits DMSO alone was injected. The injections were performed just proximal to the bifurcation of the proper hepatic artery, followed by celiac arteriography. Post mortem, the livers were examined by soft tissue radiography, and liver-tissue sections microscopically.Results:The maximum number of arterial branching points passed by embolic material in either right or left hepatic arteries was 11, 15 and 16, for 6%, 4% and 2% Onyx, respectively, but was non-measurable for 1% Onyx. Minimum diameters of arteries reached by 6%, 4%, 2% and 1% Onyx in tumorous areas were 40μm, 35μm, 20μm and 10μm, respectively, and in non-tumorous areas 35μm, 5μm, 5μm and 5μm, respectively.Conclusion:This study suggests that Onyx may be feasible for treatment of hepatic tumors.