Gelatin Sponge Research Articles

Feasibility of gel-like radiopaque embolic material using gelatin sponge and contrast agent for tract embolization after percutaneous treatment.

Tract embolization has been performed to prevent bleeding after trans-organ puncture. This study evaluated clinical outcomes of tract embolization using a gel-like radiopaque material comprising two sheets of gelatin sponge and 3 mL of contrast agent, and experimentally confirmed its viscosity and hemostatic efficacy. Three study phases were planned. In a clinical setting, 57 consecutive patients who underwent tract embolization after transhepatic puncture were retrospectively analyzed. Clinical success was evaluated as absence of bleeding complications for 30 days after the procedure. In a basic experiment, viscosity of the material was analyzed. In an animal experiment, rabbit kidney puncture site was embolized via a 7-Fr sheath using this material, coils, or N-butyl-2-cyanoacrylate glue or received no embolization while removing the sheath. Amounts of tract bleeding were measured for 1 min and compared between groups. Embolization was successfully completed in all clinical cases. No postoperative bleeding requiring intervention was encountered. The basic experiment revealed the material was highly viscous. In the animal experiment, mean weights of bleeding in the control, gel-like embolic material, coil, and N-butyl-2-cyanoacrylate glue groups were 1.04±0.32 g, 0.080±0.056 g, 0.20±0.17 g and 0.11±0.10 g, respectively. No significant differences were seen among embolization groups, while the control group showed significantly more bleeding than any embolization group. Tract embolization with this gel-like radiopaque embolic material appears safe and feasible. Tract embolization using this embolic material with two sheets of gelatin sponge and 3 mL of contrast agent offers a safe, feasible, and economical procedure after trans-organ puncture, because the material offers the following characteristics: visibility under X-ray; viscosity facilitating retention in the tract; ability to allow repeated puncture via the same route; and low cost.

Kaolin-loaded carboxymethyl chitosan/sodium alginate composite sponges for rapid hemostasis

There are several factors that contribute to the mortality of people who suffer from unmanageable bleeding. Therefore, the development of rapid hemostatic materials is necessary. Herein, novel rapid hemostatic composite sponges were developed by incorporation of kaolin (K) into carboxymethyl chitosan (CMCS)/sodium alginate (SA) via a combination of methods that includes ionic crosslinking, polyelectrolyte action, and freeze-drying. The CMCS/SA-K composite sponges were cross-linked with calcium ions provided by a sustained-release system consisting of D-gluconolactone (GDL) and Ca-EDTA, and the hemostatic ability of the sponges was enhanced by loading the inorganic hemostatic agent-kaolin (K). It was demonstrated that the CMCS/SA-K composite sponges had a good porous structure and water absorption properties, excellent mechanical properties, outstanding biodegradability, and biocompatibility. Simultaneously, they exhibited rapid hemostatic properties, both in vitro and in vivo. Significantly, the hemostatic time of the CMCS/SA-K60 sponge was improved by 82.76 %, 191.82 %, and 153.05 %, compared with those of commercially available gelatin sponges in the rat tail amputation, femoral vein, and liver injury hemorrhage models respectively, indicating that its hemostatic ability was superior to that of commercially available hemostatic materials. Therefore, CMCS/SA-K composite sponges show great promise for rapid hemostasis.

PDGF and VEGF-releasing bi-layer wound dressing made of sodium tripolyphosphate crosslinked gelatin-sponge layer and a carrageenan nanofiber layer

The use of dressings is one of the most common methods for wound treatment. Since most single-layer dressings cannot mimic the hierarchical structure of the skin well, multi-layer dressings have been considered. In this study, a bilayer dressing was fabricated using a gelatin sponge layer cross-linked with sodium tripolyphosphate (Gel-STPP) and a layer of carrageenan nanofibers containing platelet-rich fibrin (Carr-PRF). Chemical interactions between the two layers were characterized by FTIR, and the microstructure was visualized by SEM. It was found that the presence of Carr-PRF nanofiber layer increased tensile strength by 12.96 % (from 0.216 ± 0.015 to 0.268 ± 0.036 MPa) and elastic modulus by 56.70 % (from 0.388 ± 0.072 to 0.608 ± 0.029 MPa) compared to Gel-STPP sponge. Gel-STPP/Carr-PRF wound dressing had a 45.76 ± 4.18 % degradability after 7 days of immersion in phosphate buffered saline (PBS). PRF-containing bilayer wound dressing was able to sustainably release growth factors over 7 days. The Carr-PRF nanofiber layer coated on Gel-STPP sponge was an ideal environment for adhesion and proliferation of L929 cells. Gel-STPP/Carr-PRF bilayer dressing outperformed the other tested samples in terms of angiogenic potential. Average wound closure was 94.21 ± 2.06 % in Gel-STPP/Carr-PRF dressing treated rats after 14 days, and based on the histopathological and immunohistochemical examinations, the Gel-STPP/Carr-PRF dressing group augmented full-thickness wound healing, keratin layer and skin appendages formation after 14 days.

Preliminary trial of partial splenic embolization via radial artery approach

Partial splenic embolization (PSE) through radial artery utilizing 5 Fr. 125 cm catheter and 1.9 Fr. 150 cm or 1.7 Fr. 165 cm microcatheter has been conducted in six liver cirrhosis patients with splenomegaly. After inserting the catheters into the splenic artery, gelatin sponge particle and/or pushable coil embolization was performed in splenic peripheral branches. After removing the sheath, a compression wristband was utilized to stem the bleeding in the radial punctuated region. Patients were able to move immediately following the treatment and did not require any bed rest. In all, 65%-80% of the spleen's volume was embolized effectively, and no adverse events occurred during the procedure. Our data demonstrated radial technique could bring safe and satisfactory results for PSE with less discomfort for the patients after the method.

Effects of tract embolization on pneumothorax rate after percutaneous pulmonary microwave ablation: a rabbit study

Purpose To determine the effects of tract embolization with gelatin sponge particles on the prevention of pneumothorax after percutaneous microwave ablation (MWA) in rabbit lungs. Materials and methods Twenty-four New Zealand white rabbits were randomly divided into Group A (MWA followed by tract embolization with gelatin sponge particles, n = 12) and Group B (MWA without tract embolization, n = 12). For each group, CT images were reviewed for the occurrence of pneumothorax within 30 min after MWA. The rate of pneumothorax was compared by Chi-square Test. Lung tissue around the needle tract was harvested after the rabbits were euthanized, and histopathological examinations were performed and studied with hematoxylin and eosin stains. Results Twenty-four animals underwent 47 sessions of MWA (24 sessions in Group A and 23 sessions in Group B). Group A had a statistically lower rate of pneumothorax than Group B (25.0 vs. 56.5%; p = 0.028). The pathological examinations of both groups demonstrated thermal injury of the needle tract characterized by a rim of the coagulated lung parenchyma, which might be responsible for pneumothorax after MWA. Gelatin sponge particles could be arranged in irregular flakes densely to effectively seal the needle tract, thus reducing the occurrence of pneumothorax. The gelatin sponge particles could be almost completely absorbed about 14 days later. Conclusion Results of the present study showed needle tract embolization with gelatin sponge particles after CT-guided pulmonary MWA can significantly reduce the incidence of pneumothorax. Gelatin sponge particles can effectively seal the needle tract after ablation and can be completely absorbed in the body with good safety.

Advances in the development and optimization strategies of the hemostatic biomaterials.

Most injuries are accompanied by acute bleeding. Hemostasis is necessary to relieve pain and reduce mortality in these accidents. In recent years, the traditional hemostatic materials, including inorganic, protein-based, polysaccharide-based and synthetic materials have been widely used in the clinic. The most prominent of these are biodegradable collagen sponges (Helistat®, United States), gelatin sponges (Ethicon®, SURGIFOAM®, United States), chitosan (AllaQuixTM, ChitoSAMTM, United States), cellulose (Tabotamp®, SURGICEL®, United States), and the newly investigated extracellular matrix gels, etc. Although these materials have excellent hemostatic properties, they also have their advantages and disadvantages. In this review, the performance characteristics, hemostatic effects, applications and hemostatic mechanisms of various biomaterials mentioned above are presented, followed by several strategies to improve hemostasis, including modification of single materials, blending of multiple materials, design of self-assembled peptides and their hybrid materials. Finally, the exploration of more novel hemostatic biomaterials and relative coagulation mechanisms will be essential for future research on hemostatic methods.

FairEmbo Concept for Postpartum Hemorrhage: Evaluation of the Efficacy of Suture Fragment Compared with Gelatin Sponge Torpedo Embolization in a Post-Gravid Swine Model.

Postpartum hemorrhage is the leading cause of maternal mortality in emerging countries. This study aims to evaluate the effectiveness and safety of uterine artery embolization (UAE) using suture fragment (FairEmbo concept) in a swine model. Seven female swine uteri were embolized. The left uterine artery was embolized with 1 cm fragments of absorbable suture (Optime® 0), and with gelatin sponge torpedoes for the contralateral side for comparison. The embolization effectiveness and the time for arterial recanalization with digital subtraction angiography (DSA) controls at D0, D7, and M1, were evaluated. Follow-up protocol also included clinical monitoring and macroscopical analyses at M1. A Mann-Whitney test (significance at P 0.05) was used for statistics. A technical success was obtained for the seven arteries on each side, with no off-target embolization. The procedure time (10 min versus 3.7 min) and number of fragments (13.8 versus 5.7) required for complete occlusion were significantly greater in the FairEmbo group. All arteries were repermeabilized at M1. No necrosis was macroscopically visible at harvest at M1. This experimental study suggests that UAE with SBM FairEmbo method is feasible, safe, and effective in comparison with gelatin sponge procedure.

Shape memory and antibacterial chitosan-based cryogel with hemostasis and skin wound repair

Massive damage to the skin can lead to heavy bleeding and potential wound infection. Therefore, the preparation of low-cost wound dressings that meet these requirements by simple methods has a good application prospect. In the study, a shape memory cryogel prepared at low temperatures by mixing chitosan (CS) and citric acid (CA). Silver nanoparticles (Ag NPs) introduced into the cryogel through the reduction of Ag+ with tannic acid (TA) as a reducing agent. The CS/CA/Ag cryogel has good mechanical properties and interconnected macroporous structures. The results of hemostasis tests show that CS/CA/Ag cryogel can absorb a large amount of blood and promote blood cell adhesion compared with commercial gelatin sponges and gauze. Meanwhile, CS/CA/Ag cryogel has a good antibacterial ability against S. aureus and E. coli. Furthermore, CS/CA/Ag cryogel significantly promotes wound healing in the full-thickness wound model infected with S. aureus. In conclusion, the cryogel prepared by the simple method has great advantages in rapid hemostasis and promoting wound healing.

Robotic-assisted Kasai portoenterostomy for biliary atresia.

Robotic-assisted Kasai portoenterostomy (RAKPE) has been utilized to treat biliary atresia (BA). However, RAKPE is not widely performed and its efficacy remains unknown. We summarized the experience of RAKPE for BA and determined its efficacy. We retrospectively analyzed 25 consecutive infants with non-syndromic type III BA who received RAKPE in our center from January 2020 to July 2021. RAKPE is a three-arm setup and four-trocar operation. Bipolar coagulation was used to dissect the small blood vessels at the hepatic portal. The fibrous cone was shallowly transected with bending electric scissors, followed by gelatin sponge compression to staunch the hemorrhage. Finally, a wide anastomosis was accurately constructed. Demographics and outcomes were recorded. The mean operative time was 211.64 ± 18.93min. No conversion to laparotomy or intraoperative complications occurred. The mean estimated blood loss was 7.64 ± 2.43mL. Enteral feeding was resumed after 3.44 ± 1.23days. All patients achieved bile excretion postoperatively, and dark green bile-stained stools were passed 1.50days (range 1.00-3.00days) after surgery. The average postoperative length of hospital stay was 10.32 ± 2.59days. The jaundice clearance (JC) rate was 76.00% within 6months after surgery and the incidence of cholangitis was 48.00% within 1year following surgery. The survival with native liver (SNL) rate was 80.00% at 1year and 66.67% at 2years. RAKPE can be regarded as a treatment option for patients with BA due to the good outcomes reported. However, long-term studies comparing open or laparoscopic approaches are needed.

THE ROLE OF INTERVENTIONAL RADIOLOGISTS IN THE TREATMENT OF COMPLICATIONS IN UROLOGIC PATIENTS.

Higher turnaround of urologic patients in the tertiary clinical center can lead to more accompanying complications, ranging from 1% to 55% for various procedures, with the incidence of vascular injuries varying from 0.43% up to 9.5%. In patients with impaired renal function, it is imperative to prevent the loss of normal kidney function and potential hemodialysis. Being minimally invasive, endovascular procedures such as renal artery embolization (RAE) can treat major and life-threatening complications, but good and prompt communication between urologists and interventional radiologist is necessary for fast and effective treatment. Absolute contraindications for RAE are the presence of acute infection and previously known anaphylactic reaction to the iodine contrast media, while previous mild or moderate allergic reactions to iodine contrast media are not contraindications for RAE. Currently used embolic agents can be divided into temporary and permanent embolization agents. While the temporary embolization agent available is a gelatin sponge that could be used as complementary material or stand-alone, for permanent embolization interventional radiologists use microparticles, microspheres, liquid embolic agents, coils, and microcoils. RAE procedures are considered to be safe with a low incidence of complications, with non-target embolization being the most serious one. Postembolization syndrome is considered to be the most common adverse effect and it involves around 90% of patients. The overall results show that RAE is a safe, minimally invasive procedure that can effectively treat significant complications caused by other urologic procedures, with the reported success rates of 87%-100%.

The Role of Absorbable Gelatin Sponge (Gel Foam) in Control of Sternal Bleeding during Cardiac Surgery

The Role of Absorbable Gelatin Sponge (Gel Foam) in Control of Sternal Bleeding during Cardiac Surgery

Повышение устойчивости полного протеза слуховых косточек

When performing tympanoplasty, one of the key stages is ossiculoplasty – reconstruction of the chain of auditory ossicles through prosthetics. When the chain of auditory ossicles, including the superstructure of the stapes, is destroyed, complete ossicular prostheses are used. The main task of the surgeon when performing ossiculoplasty is to achieve a balance of reliable functional position of the prosthesis ensured by lateral stability, on the one hand, and the exclusion of its contact with surrounding immobile anatomical elements, on the other. According to the literature, the frequency of dislocation of a total prosthesis reaches 13%. The study included 159 patients divided into a study group (72 patients) and a comparison group (87 patients) who underwent ossiculoplasty using a total ossicular prosthesis between 2017 and 2021. In the comparison group, the stability of the prosthesis was ensured by fragments of highly purified gelatin sponge. In the study group, an oval plate of autologous cartilage graft measuring 2,5 and 3,5 mm was additionally used, attached to the prosthetic socket. The results of postoperative observation showed a statistically significant (p < 0,05) reduction in the incidence of prosthesis dislocation to 4,2% compared to the comparison group (10,8%). Functional results were also statistically better when comparing subgroups of patients who underwent tympanoplasty with a first stage using a closed technique.

Harvest of functional mesenchymal stem cells derived from in vivo osteo-organoids.

Bone marrow-derived mesenchymal stem cells (BM-MSCs) play a crucial role in stem cell therapy and are extensively used in regenerative medicine research. However, current methods for harvesting BM-MSCs present challenges, including a low yield of primary cells, long time of in vitro expansion, and diminished differentiation capability after passaging. Meanwhile mesenchymal stem cells (MSCs) recovered from cell banks also face issues like toxic effects of cryopreservation media. In this study, we provide a detailed protocol for the isolation and evaluation of MSCs derived from in vivo osteo-organoids, presenting an alternative to autologous MSCs. We used recombinant human bone morphogenetic protein 2-loaded gelatin sponge scaffolds to construct in vivo osteo-organoids, which were stable sources of MSCs with large quantity, high purity, and strong stemness. Compared with protocols using bone marrow, our protocol can obtain large numbers of high-purity MSCs in a shorter time (6 days vs. 12 days for obtaining passage 1 MSCs) while maintaining higher stemness. Notably, we found that the in vivo osteo-organoid-derived MSCs exhibited stronger anti-replicative senescence capacity during passage and amplification, compared to BM-MSCs. The use of osteo-organoid-derived MSCs addresses the conflict between the limitations of autologous cells and the risks associated with allogeneic sources in stem cell transplantation. Consequently, our protocol emerges as a superior alternative for both stem cell research and tissue engineering.

Transarterial Chemoembolization for Hepatocellular Carcinoma: 2023 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association.

Transarterial chemoembolization (TACE) was introduced in 1977 with the administration of chemotherapeutic agent to gelatin sponge particles through the hepatic artery in patients with hepatocellular carcinoma (HCC) and was established as conventional TACE using Lipiodol in the 1980s. In the 2000s, drug-eluting beads were developed and applied clinically. Currently, TACE is a commonly used non-surgical treatment modality for patients with HCC who are unsuitable for curative treatment. Considering the vital role of TACE in the management of HCC, it is crucial to organize current knowledge and expert opinions regarding patient preparation, procedural techniques, and post-treatment care in TACE, which can enhance therapeutic efficacy and safety. A group of 12 experts in the fields of interventional radiology and hepatology, convened by the Research Committee of the Korean Liver Cancer Association (KLCA), has developed expert consensus-based practical recommendations in TACE. These recommendations have been endorsed by the Korean Society of Interventional Radiology and provide useful information and direction in performing TACE procedure as well as pre- and post-procedural patient care.

Short- and long-term efficacy of bronchial artery embolization using a gelatin sponge for the treatment of cryptogenic hemoptysis.

Bronchial artery embolization (BAE) is the first choice treatment for hemoptysis. With advances in endovascular treatment, various embolic materials have become available. However, the optimal embolic material for the treatment of cryptogenic hemoptysis has not been determined. This study aimed to investigate the short-and long-term efficacy of BAE using a gelatin sponge in the treatment of patients with cryptogenic hemoptysis. The clinical characteristics, angiographic findings, and short- and long-term outcomes of BAE were retrospectively analyzed in 22 consecutive patients who underwent BAE for control of cryptogenic hemoptysis between January 2010 and September 2018. Selective angiography and super-selective BAE were successfully performed for all patients. A gelatin sponge was used in all patients. Further, polyvinyl alcohol was mixed with the gelatin sponge in 11 patients (50%). Angiography showed that the bronchial artery was responsible for hemoptysis in all patients, along with the intercostal artery in one patient (4.5%) and the inferior phrenic artery in one patient (4.5%). Immediate hemostasis was achieved in all patients. The recurrence-free rate was 100% for 1 month, 94.1% for 3 months, 94.1% for 12 months, and 87.4% for 24 months. Of two patients with recurrent hemoptysis, one underwent bronchoscopic hemoptysis and the other received intravenous hemostatic agents. No patient underwent BAE for recurrence. No severe complications occurred. In conclusion, BAE using a gelatin sponge has short- and long-term hemostatic efficacy for treating cryptogenic hemoptysis without any severe complications. A gelatin sponge is a suitable embolic material for patients with cryptogenic hemoptysis.

Transarterial Embolization for Spontaneous Soft-Tissue Hematomas: Predictive Factors for Early Death.

The aim of this retrospective monocentric study was to assess the safety and efficacy of spontaneous soft-tissue hematoma transarterial embolization (TAE) and to evaluate predictive factors for early mortality (≤30 days) after TAE for spontaneous soft-tissue hematoma (SSTH). Between January 2010 and March 2022, all patients referred to our hospital for spontaneous soft-tissue hematoma and treated by emergency TAE were reviewed. Inclusion criteria were patients: ≥18-year-old, with active bleeding shown on preoperative multidetector row computed tomography, with spontaneous soft-tissue hematoma, and treated by TAE. Exclusion criteria were patients with soft-tissue hematomas of traumatic, iatrogenic, or tumoral origin. Clinical, biological, and imaging records were reviewed. Imaging data included delimitation of hematoma volume and presence of fluid level. Univariate and multivariate analyses were performed to check for associations with early mortality. Fifty-six patients were included. Median age was 75.5 [9-83] ([Q1-Q3] years and 23 (41.1%) were males. Fifty-one patients (91.1%) received antiplatelet agent and/or anticoagulant therapy. All 56 patients had active bleeding shown on a preoperative CT scan. Thirty-seven (66.0%) hematomas involved the retroperitoneum. Median hemoglobin level was 7.6 [4.4-8.2] g/dL. Gelatine sponge was used in 32/56 (57.1%) procedures. Clinical success was obtained in 48/56 (85.7%) patients and early mortality occurred in 15/56 (26.8%) patients. In univariate and multivariate analysis, retroperitoneal location and volume of hematoma were associated with early mortality. Retroperitoneal location and volume of hematoma seem to be risk factors for early death in the context of TAE for spontaneous soft-tissue hematoma. Larger multicenter studies are necessary to identify others predictive factors for early mortality and to anticipate which patients may benefit from an interventional strategy with TAE.

Comparative Clinical Study Between Chlorhexidine Gel (0.2%) and Hyaluronic Gel (1%) in the Prevention of a Dry Socket After Tooth Extraction for Orthodontic Treatment.

Introduction Several articles have investigated the intra-alveolar applications of bioadhesive gels containing various medicines and active chemicals, such as chlorhexidine (CHX) and hyaluronic acid (HA) to minimize the numerous postoperative sequelae, such as a dry socket. The purpose of this study was to investigate the postoperative outcomes of intra-alveolar application of 0.2% chlorhexidine or hyaluronic acid following atraumatic extraction. Methods A randomized clinical trial was conducted on a sample of 36 patients who need extraction of lower first premolar for orthodontic treatment. The patients were assigned randomly into two groups: CHX group andHA group. The signs and symptoms of the dry socket were evaluated on the third day in two groups. Results There was no statistically significant difference between the study and control groups when comparing the CHX group (P=0.2.6). In contrast, a significant difference was seen between the study and control sides in the HA group. Conclusions Within the limitation of this clinical trial, using hyaluronic gel with a gelatin sponge may be a preventive strategy for a dry socket following tooth extraction. After non-surgical tooth extraction, the topical administration of CHX with a gelatin sponge as a carrier did not seem to act as a protective substance against a dry socket.

A brief review of dural venous sinus injury with a short case series

BackgroundDural venous sinus injury results in torrential hemorrhage and exsanguination. The initial review by Harvey Cushing had shown high mortality. The depressed fractures over sinuses were managed conservatively, because of the risk of massive hemorrhage during elevation. The consequences of sinus injury are hemorrhage, intracranial hypertension, brain swelling and venous infarct. Topical hemostatic agents such as gelatin sponge, oxidized cellulose, hemostatic matrix, bioresorbable plate, tissue-glue-coated collagen sponge, and fibrin glue help in controlling bleeding during surgery. The aim of the study is to analyze five cases of traumatic dural venous sinus injury. The literature review was done from Pubmed, Scopus and Google Scholar. A retrospective and descriptive analysis is done.Case presentationAmong the five cases described, four had injury to superior sagittal sinus and one had injury to the transverse sinus. Two patients had open wounds. Three patients had continuous bleeding and two had intracranial hypertension. Decompressive craniectomy was done in three patients, wound hemostasis and closure in one, and craniotomy and evacuation of hematoma in one. Compression with Gelfoam was the main method for hemostasis and thrombin–gelatin hemostatic matrix had to be applied in two patients, with continued pressure for one hour.ConclusionsInjury to the dural venous sinus should be suspected in fracture over the venous sinus. Surgery is indicated in active bleeding, expanding hematoma, compression or occlusion of the sinus and intracranial hypertension. Topical hemostatic agents help in controlling the bleed. Morbidity and mortality are more with involvement of middle and posterior third of superior sagittal sinus.

Succinic Ester-Based Shape Memory Gelatin Sponge for Noncompressible Hemorrhage without Hindering Tissue Regeneration.

Shape memory sponges are very promising in stopping the bleeding from noncompressible and narrow entrance wounds. However, few shape memory sponges have fast degradable properties in order to not hinder tissue healing. In this work, based on cryopolymerization, a succinic ester-based sponge (Ssponge) is fabricated using gelatin and bi-polyethylene glycol-succinimidyl succinate (Bi-PEG-SS). Compared with the commercially available gelatin sponge (Csponge), Ssponge possesses better water/blood absorption ability and higher mechanical pressure over the surrounding tissues. Moreover, in the models of massive liver hemorrhage after transection and noncompressive liver wounds by penetration, Ssponge exhibits a better hemostasis performance than Csponge. Furthermore, in a liver regeneration model, Ssponge-treated livers shows higher regeneration speed compared with Csponge, including a lower injury score, more cavity-like tissues, less fibrosis and enhanced tissue regeneration. Overall, it is shown that Ssponge, with a fast degradation behavior, is not only highly efficient in stopping bleeding but also not detrimental for tissue healing, possessing promising clinical translational potential.

Comparison of 8spheres polyvinyl alcohol microsphere and gelatin sponge particle efficacy for transcatheter arterial chemoembolization in stages A to B patients with hepatocellular carcinoma.

This study aimed to compare the clinical efficacy and prognostic analysis results of 8spheres polyvinyl alcohol (PVA) microspheres (8SM) with gelatin sponge (GS) particles for transcatheter arterial chemoembolization (TACE) in patients with stages A-B hepatocellular carcinoma (HCC). Data were collected from 172 patients who underwent TACE at Harbin Medical University Cancer Hospital from January 2014 to July 2020. Patients were divided into two groups: TACE group using 8SM plus lipiodol (8spheres PVA group, N = 89) and TACE group using GS particles plus lipiodol (the GS group, N = 83). Subsequently, we compared the liver function, blood count, alpha-fetoprotein (AFP), and other parameters of patients in each group before and after interventional embolization. We also calculated the patient's progression-free survival and overall survival in these groups. The postoperative liver function indices, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the 8spheres PVA group, were worse than in the GS group. The postoperative median survival time was 19 ± 3.06 months and no significant difference in survival time was observed in GS group (26 ± 3.19 months) (P = 0.509). Multivariate analysis showed that targeted therapy (P = 0.051), maximum tumor diameter <5 cm (P = 0.018), age ≥60 years (P = 0.018), and AFP <120.5 μg/L (P = 0.007) significantly improved the overall survival rate of patients. Postoperative liver function indices of patients with HCC treated with GS particles were better than those treated with 8SM; thus, GS particles are more suitable for patients with poor liver function.