Abstract
ObjectivesTo develop an ex- vivo perfusion flow model using a bovine kidney for future testing of embolic agents in an inexpensive and easy way.MethodsSix bovine adult kidneys were used for this study. Kidneys were cannulated and perfused via a roller pump. Three embolic agents, coils, Gelfoam, and a glue mixture of Histoacryl + Lipiodol, were deployed by targeting three secondary segmental arteries per kidney via a 5Fr catheter under fluoroscopic guidance. Cannulation time, success rate of segmental artery selection and embolic agent deployment, total operational time, and fluoroscopy dose were recorded.ResultsAverage kidney weight was 0.752 +/− 0.094 kg. All six bovine kidneys were successfully cannulated in 21.6 min +/− 3.0 min. Deployment of coils and glue was achieved in every case (12/12); however, Gelfoam injection was not successful in one instance (5/6, 83%). Coil deployment demonstrated no embolic effect while Gelfoam and glue injections demonstrated decreased distal contrast filling post-embolization. Mean dose area product was 12.9 ± 1.8 Gy·cm2, fluoroscopy time was 10 ± 4 min and operational time was 27 ± 8 min.ConclusionsWe describe the creation of an ex vivo bovine kidney flow model for the preclinical evaluation of different embolic materials. The flow model can be modified to provide extensive bench testing and it is a promising tool for hands -on training in basic and advanced embolization techniques .
Highlights
Therapeutic vascular embolization procedures represent established treatment options for a variety of conditions such as hemorrhage, tumor, and vascular malformations (Moreira and An 2003)
Non-selective digital subtraction angiography (DSA) demonstrated overall homogeneity in the vascular anatomy of bovine kidneys, with the renal artery dividing into a cranial and a caudal primary segmental arteries to supply the cranial and caudal poles, respectively
Contrast extravasation was noted in some kidneys due varying degrees of parenchymal damage prior and upon perfusion that were related to tissue degradation of the frozen tissues, despite this limitation, we noticed that foci of contrast extravasation decreased after deployment of embolic materials, which implies that embolic agents were retained in the vascular bed of the selected artery, and that novel embolic materials could be preliminarily tested using a similar flow model to characterize embolic agent behavior and vascular distribution effects
Summary
Therapeutic vascular embolization procedures represent established treatment options for a variety of conditions such as hemorrhage, tumor, and vascular malformations (Moreira and An 2003). Preclinical testing of embolic materials has been extensively described in live animals (Oh et al 2015; Barbosa L de et al 2009; Sommer et al.2011; Siskin et al 2003). It is essential to study and test novel embolic materials in animal tissue prior to human clinical trials; formalized in-vivo trials may be taxing and resource consuming. Bench testing to characterize the behavior of novel embolic materials in an organ flow model may aid in selecting promising materials to proceed into live animal studies. It may prove beneficial to establish a simple ex-vivo perfusion model for the pre-clinical evaluation of embolic agents. There is no description of an exvivo perfusion model of a bovine kidney to deploy embolic materials. The bovine kidney’s total volume and vascularity size facilitate the testing of embolic agents, without requiring specialized angiography catheters (2021) 4:20
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