Polyvinyl Alcohol Particles Research Articles

Middle meningeal artery embolization combined with surgical evacuation for chronic subdural hematoma: A single-center experience of 75 cases.

Chronic subdural hematoma (cSDH) is a challenging and common neurosurgical condition. Our goal is to demonstrate that middle meningeal artery (MMA) embolization combined with surgical evacuation can be a promising adjuvant option for treatment of cSDHs and prevent recurrence in symptomatic patients who require surgical treatment. We retrospectively collected data from patients who underwent MMA embolization using polyvinyl alcohol particles and surgical evacuation with burr hole or craniotomy in a single center for the treatment of new and recurrent cSDHs. The primary outcome was recurrence of cSDH requiring surgical rescue during follow up, and secondary outcomes were defined as >50% decrease in the maximum width of cSDHs on the longest follow-up computed tomography (CT) scan, complications following procedure, and improvement in modified Rankin scale (mRS) score. A total of 51 patients successfully underwent 72 MMA embolization procedures (96% of the total 75 cases in the cohort) combined with surgical evacuation. Seventy cases (93.3%) achieved at least 50% reduction in the size of the cSDHs on the last CT imaging. A surgical evacuation was required in five cases (6.7%) due to cSDH recurrence during the follow-up period. There were three complications (6.0%) related to embolization procedure. Forty patients (78.4%) showed improvement in mRS score. There was one mortality (2%) regardless of the embolization and evacuation. Our study demonstrates the safety and efficacy of adjunct MMA embolization in significantly reducing size and recurrence of cSDHs.

KURUTMA SICAKLIĞININ KURKUMİN VE PİPERİN ÇÖZÜNMESİNE VE KATI DİSPERSİYON BAZLI MİKROPARTİKÜLLERİN SALINIM KİNETİĞİNE ETKİLERİ: BİR ÖN ÇALIŞMA

Objective: One of the major challenges in developing curcumin as a pharmaceutical agent is its low bioavailability after oral administration. Co-administration of curcumin-piperine combined with employing solid dispersions (SD) approach has been shown to enhance curcumin dissolution and bioavailability. Understanding the influence of the processing temperature during spray drying is crucial in SDs preparations; the purpose of this study is to inquire the effect of inlet temperature spray-dryer on dissolution behavior and the best-fit kinetic model of dissolution itself. Material and Method: The SD powder was prepared using a spray-drying method by varying the inlet temperature (105°C; 115°C; 125°C) and involved polyvinyl alcohol (PVA) as a carrier. The SD were prepared at 30% Curcuma longa and 10% Piper nigrum extracts. Yield (%) of the dried powder resulted from the spray drying process was monitored, and dissolution behavior of curcumin and piperine were analyzed using a dissolution efficiency (DE) value. Furthermore, mathematical model describing the release mechanism of curcumin and piperine from the dissolution were evaluated using a DDSolver software. Result and Discussion: The variation of drying temperature on the spray dryer affects the dissolution behavior and the % yield of the PVA-based SD containing C. longa and P. nigrum extract. The most ideal mathematical model of kinetic release for curcumin and piperine were the Quadratic model, indicating that the mechanism of dissolution is diffusion through a gap between the PVA particle and the surrounding medium.

Middle meningeal artery embolization may be an effective treatment for patients with chronic subdural hematoma resistant to atorvastatin

ObjectiveTo investigate the efficacy and safety of MMA embolization in patients with CSDH who failed atorvastatin treatment. MethodsSeventeen CSDH patients who failed atorvastatin treatment from Jan 1, 2021 to Dec 31, 2021 were included in the study. All patients were treated with MMA embolization using polyvinyl alcohol (PVA) particles. ResultsTwenty-six MMAs (unilateral embolization in 8 patients and bilateral embolization in 9 patients) were successfully embolized in all patients. Hematoma re-accumulated in only one patient (5.9%) after MMA embolization and was surgically evacuated. Procedural adverse events, mortality, or complications were not observed. At the last follow-up of an average of 51.5 days post MMA embolization, maximum hematoma thickness improved in 95.2% of CSDHs with a mean reduction of 52.1%, while mRS score improved in 94.1% of patients. In addition, 5 (29.4%) patients with unilateral hematoma underwent bilateral MMA embolization and hematoma absorbed completely in all 5 cases. ConclusionsMMA embolization may be a minimally invasive alternative to surgical evacuation for CSDH patients resistant to atorvastatin. In unilateral CSDH, bilateral superselective angiography and bilateral MMA embolization could be a useful and effective treatment strategy.

Middle meningeal artery embolization with polyvinyl alcohol particles in a patient with ophthalmic artery origin from middle meningeal artery: Case report and technical note.

This is a case report of an adult with chronic subdural hematoma (cSDH) who underwent endovascular treatment for middle meningeal artery (MMA) embolization. There was a prominent meningo-ophthalmic branch with an absence of an ophthalmic artery from the internal carotid artery. MMA embolization was performed utilizing particles with no complications and the resolution of the cSDH was within 4 months. This case report demonstrates that despite extreme variant anatomy, MMA embolization with particles is feasible, effective, and safe when appropriate techniques are used.

Pre-operative Embolization of Meningioma Leads to Reduced Operating Time and Less Intraoperative Bleeding

Objective: To determine the efficacy of pre-operative meningioma embolization in terms of operating time and intraoperative bleeding.
 Study Design: Prospective longitudinal study.
 Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2020.
 Methodology: Twelve diagnosed cases of intracerebral meningioma were included in the study. The patients were diagnosed cases of meningioma as per pre-operative signs and symptoms, radiological confirmation was done with magnetic resonance imaging, and all were subjected to pre-operative embolization of the tumour with catheter advancement in the arterial system and embolizing the target vessels with polyvinyl alcohol particles, followed by craniotomy and excision of the tumour.
 Results: The mean age of the patients was 47±672. 24 years. The mean operating time (from the incision to closure) was 96.17±10.23 minutes. In contrast, the intraoperative blood loss was 325.33±15.43 ml. Six (50.00%) individuals had parasagittal meningioma, 4(33.33%) were of cerebral convexity, while 2(16.66%) had lesions at sphenoid wing.
 Conclusion: Meningioma is a quite vascular tumour, and the operative outcome can be improved by pre-operative angioembolization. The reduced vascularity makes the resection easier by decreasing the per-op bleed and operating time.Keywords: Intraoperative bleed, Meningioma, Operating time, Pre-operative embolization.

N-Butyl Cyanoacrylate Glue Versus Nonspherical Polyvinyl Alcohol Particles For Prostatic Arterial Embolization To Treat Benign Prostatic Hyperplasia: Safety And Efficacy.

Our aim is to compare N-butyl cyanoacrylate (NBCA) glue and non-spherical polyvinyl alcohol (PVA) particles for prostatic artery embolization (PAE) for patients with benign prostatic hyperplasia (BPH) to treat lower urinary tract symptoms (LUTS) and report their feasibility, safety, and short-term effectiveness. 110 patients (mean age: 72.6 years) with BPH related to LUTS divided into two groups, PAE was performed in one group with 250 - 355 μm non-spherical PVA particles. Whereas, the other group received mixture of NBCA glue/ lipiodol for PAE. PAE was technically successful in all 110 patients (100 %). During 6 months follow up, we found that patients who received NBCA glue, the mean of prostatic volume (PV) was significantly reduced compared to baseline (67.1 ± 8.5 to 40.2 ± 5.4), International Prostate Symptom Score (IPSS) (25.7 ± 4.3 to 7.2 ± 1.09), Quality of life (QoL) (4.43 ± 0.27 to 1.58 ± 2.27) Whereas, the mean of Peak urinary flow (Qmax) increased significantly from baseline to 6 months (8.6 ± 2.3 to 15.4 ± 2.3), International Index of Erectile Function (IIEFS) (9.46 ± 1.51 to 19.3 ± 1.33). Meanwhile, non-spherical PVA particles used in the other group shows PV was significantly reduced from baseline to 6 months (68.2 ± 8.32 to 38.8 ± 6.13), IPSS (25.0 ± 3.59 to7.24 ± 0.83), QoL (4.43 ± 0.24 to1.56 ± 0.55). The mean for Qmax increased from baseline to 6 months (7.19 ± 1.67 to15.1 ± 2.42), IIEFS (9.22 ± 1.30 to 19.5 ± 0.96). PAE with NBCA glue and non-spherical PVA particles are feasible, safe and effective for patients with BPH related-LUTS. This gives the physicians options to choose between embolizing agents based on the architecture of the prostatic artery.

Efficacy of Embolization in Acquired Uterine Vascular Malformations: An Experience in Tertiary Care Centre in India.

To determine the efficacy of Uterine Artery Embolization in patients with bleeding acquired uterine arteriovenous malformations (AVMs). A prospective review of all patients who underwent Uterine Artery Embolization at our institution between July 2015 and April 2022 was performed. 225 patients were diagnosed with a uterine vascular malformation on doppler and corresponding MRI imaging. All patients underwent transcatheter embolization of the uterine arteries. Embolic agents in the 375 procedures included Histoacryl glue only (n = 326), polyvinyl alcohol (PVA) particles and Histoacryl glue (n = 29), PVA particles (n = 5), Gelfoam (n = 5), coils (n = 4), PVA particles and coils (n = 3), Histoacryl glue and Gelfoam (n = 2), and Histoacryl glue and coils (n = 1). A total of 375 embolization procedures were performed in 225 patients. 90 patients required repeat embolization for recurrence of bleeding. The technical success rate of embolization was 100%. The clinical success rate was 92%: bleeding was controlled in 222 of 225 patients and three patients underwent a hysterectomy. 60 of the 225 patients had uneventful intrauterine pregnancies carried to term. The 210 patients who underwent successful embolization had no recurrence of bleeding at a median follow-up of 53 months (range, 5-122 months) after treatment. 15 patients were eventually lost to follow-up. One minor complication (0.4%) of non-flow-limiting dissection of the internal iliac artery occurred. Uterine Artery Embolization is a safe, effective, minimally invasive method to treat uterine AVMs with long-term efficacy, which can provide the preservation of fertility.

In vitro comparison of middle meningeal artery embolization with Squid liquid embolic agent and Contour polyvinyl alcohol particles

BackgroundLiquid embolic agents and polyvinyl alcohol (PVA) particles have been used for the embolization of the middle meningeal artery (MMA) for the treatment of chronic subdural hematomas. However, the vascular...

Experimental study of the effects of absorbable gelatin sponge and non‑absorbable polyvinyl alcohol particle material used in transcatheter arterial embolization on liver tissues.

Hepatic trauma is a leading cause of death in major abdominal trauma, and transcatheter arterial embolization has been widely used to treat it. However, there is limited research on whether absorbable gelatin sponge (AGS) and non-absorbable polyvinyl alcohol particles (PVA) have different effects on liver tissue, making it an important area of exploration. The present study investigated this issue using animal experiments by performing transhepatic arterial embolization with AGS and PVA. The effects on normal liver tissue in rabbits were examined by detecting liver function and inflammatory indexes, conducting histopathological examination, and using western blotting to detect apoptotic proteins. There were significant differences between the AGS and PVA groups after embolization. The AGS group exhibited a trend of improvement at ~1 week after embolization, and all indicators were statistically different until day 21 compared with the PVA group. The AGS group exhibited improved repair of hepatocytes and the biliary system based on H&E staining, while the PVA group exhibited more severe necrosis of the hepatocytes and biliary system around the embolization site. The western blotting results indicated that the Bcl-2/Bax ratio decreased on day 1 and day 3, and then rebounded in the AGS group on days 7 and 21, demonstrating gradual repair of hepatocytes compared with the PVA group.

Transarterial arterial sclerosing embolization for the treatment of propranolol-resistant subglottic hemangioma: Feasibility and effificacy.

To assess the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of subglottic hemangiomas that did not respond appreciably to propranolol. This study was a retrospective analysis. Of the 101 patients with subglottic hemangiomas admitted to our center, 10 (4 male and 6 female) patients were included in this study. All these patients underwent arterial embolization using Pingyangmycin and polyvinyl alcohol particles (300-500 μm). All patients were examined 1 month after the last treatment and monthly thereafter. TASE treatment was technically successful in all patients. Ten lesions were located in the subglottic region. The blood supply included the superior thyroid artery, brachiocephalic trunk, facial artery, and ascending pharyngeal arteries. The median maximal diameter of the hemangiomas significantly decreased from 8.5mm before treatment to 2mm after TASE (P <.05). The degree of laryngeal obstruction improved in all patients. No serious complications were noted. One patient developed fever postoperatively, and three patients had a mild cough. For even subglottic hemangiomas with suboptimal efficacy of propranolol, TASE significantly reduced the size of hemangiomas with minimal adverse effects. It had a positive effect on the improvement of airway stenosis caused by subglottic hemangioma with poor effect of oral propranolol.

Comparison of polyvinyl alcohol particles and tris-acryl gelatin microspheres embolic agents used in uterine artery embolization: A systematic review and meta-analysis.

To identify the preferred agent by comparing the therapeutic efficacy, degree of infarction, and side effects of polyvinyl alcohol particles (PVA) and tris-acryl gelatin embolization (TAGM) agents in uterine artery embolization. We included available articles comparing PVA with TAGM embolization agents in the management of fibroids. The primary outcomes included the decrease in uterine volume (%), decrease in dominant tumor volume (%), fibroid infarction rate, complete infarction fibroid, complications, pain score after 24 h, procedure time (minutes), duration of hospital stay, fluoroscopy time (minutes), and the change in symptom severity score. Eight articles that met our inclusion criteria were included in this study. Our analysis yielded an overall superiority of PVA compared to TAGM regarding complete fibroid infarction rate at the first 24 h. However, TAGM was better than PVA concerning <90% infarction rate outcome. While both embolization techniques showed similar effects regarding the change in symptom severity score, the percentage of decrease in uterine volume, percentage of decrease of dominant tumor volume, 90-99% infarction rate, complete infarction rate when assessed after the first 24 h, pain score after the first 24 h, procedure time, fluoroscopy time, minor, and major complications. Both PVA and TAGM embolization agents are effective and safe modalities in treating patients with fibroids, with no significant variation of both agents in most outcomes.

Thermal Properties of Carbon Nanofiber Sheet for Thermal Interface Materials under High Temperature and Humidity

In this study, polyvinyl alcohol (PVA) - polytetrafluoroethylene (PTFE) - vapor grown carbon fiber (VGCF) sheets are fabricated as a new paper-like thermal interface material (TIM), which is a potential substitute for traditional TIMs. Two types of PVA-PTFE-VGCF sheets were fabricated by using 120 nm and 300 nm PTFE particles. The microstructure shows that the VGCFs were arranged in random directions inside the sheet and interconnected via the aggregate of PVA. 300 nm PTFE particles were well distributed within the sheet, while 120 nm PTFE particles aggregated partially and formed pores nearby. The fabricated sheets have a low thickness of 31.2 um and 28.2 um, and lightweight properties with a density of 0.79 × 106 g·m−3 and 0.91 × 106 g·m−3, respectively. With the addition of 300 nm PTFE particles, the fabricated sheet has higher thermal conductivities of 9.81 W·m−1·k−1 in the in-plane direction and 2.11 W·m−1·k−1 in the through-plane direction. In the high temperature and humidity test, the thermal conductivities of the fabricated sheet were increased due to the rearrangement of PVA and PTFE particles.

Intramuscular hemangioma presenting as pathological femur fracture: A case report

Hemangioma is a common benign soft-tissue tumor; however, intramuscular hemangioma presenting with a pathological fracture is an infrequent occurrence. Imaging plays a key role in diagnosing this entity. We report a case of a 30-year-old male who presented with a pathological fracture of the left femur following trivial trauma. Clinical examination was remarkable for a significant soft-tissue swelling which on further radiological investigation revealed a soft-tissue mass lesion in the left thigh muscles having multiple vascular channels and phleboliths extending into femoral cortex and medulla causing a pathological fracture. Diagnosing it as an aggressive hemangioma, the main feeder artery was embolized by polyvinyl alcohol particles. The patient is on traction and follow-up. Intramuscular hemangioma causing pathological fracture is extremely rare. Understanding the typical and atypical radiological findings of an intramuscular hemangioma will impede misdiagnosis, and unnecessary tissue sampling, and allow for expedited and appropriate management.

Bronchial artery chemoembolization with drug-eluting beads versus bronchial artery infusion followed by polyvinyl alcohol particles embolization for advanced squamous cell lung cancer: A retrospective study

PurposeTo analyze the efficacy and safety of bronchial arterial embolization (BACE) with drug-eluting beads (DEB) versus bronchial artery infusion (BAI) followed by polyvinyl alcohol (PVA) particle embolization for the treatment of advanced squamous cell lung cancer after the failure of systemic therapy. MethodThirty-six patients with advanced squamous cell lung cancer who underwent bronchial arterial interventional therapy were included in this retrospective study. The DEB group (n = 20) was treated with nedaplatin and DEB loaded with gemcitabine, and the PVA group (n = 16) BAI with nedaplatin and gemcitabine followed by embolization with PVA particles. The treatment efficacy and complications were analyzed. ResultsThe technical success rate was 100 %. The two groups were followed up for a median period of 8.9 months. The mean overall survival (OS) in the DEB group was 12.6 months (95 % CI:9.99–15.21), which was significantly longer than 8.14 months (95 % CI:6.07–10.2) in the PVA group (p = 0.007). The median progression-free survival (PFS) in the DEB group was 4.3 months (95 % CI:2.33–6.27), significantly longer than 3.2 months (95 % CI:2.55–3.85) in the PVA group (p = 0.030). The objective response rate (ORR) six months after the procedure was 50 % in the DEB group and 12.5 % in the PVA group. In the univariate and multivariate analyses, DEB-BACE was an independent prognostic factor for survival. Only grade 1 adverse events like fever, chest pain, and cough were seen. ConclusionsDEB-BACE may be a good choice for patients with advanced lung squamous cell carcinoma, as it could prolong OS and PFS without increasing adverse events.

Compressive Test Investigation and Numerical Simulation of Polyvinyl-Alcohol (PVA)-Fiber-Reinforced Rubber Concrete

To investigate the mechanical properties of polyvinyl-alcohol (PVA)-fiber-reinforced rubber concrete, 13 groups of PVA rubber/concrete specimens with PVA volume fractions of 0%, 0.5 vol%, 1.0 vol%, and 1.5 vol% and rubber particles with volume replacement sand ratios of 0%, 10%, 20%, and 30% were prepared, and the uniaxial compression full curve test was performed. The findings indicate that the bridging effect of PVA, as well as the synergistic effect of PVA and rubber particles, can improve the compressive properties of concrete, and the failure of the specimens demonstrates obvious ductile characteristics. Furthermore, PVA has a better impact on rubber concrete’s bearing capacity, crack propagation of the failure surface, and compressive strength in the latter stages. PVA-fiber-reinforced rubber concrete is thought to be a six-phase composite made up of the aggregate phase, mortar matrix, PVA fiber, rubber particles, aggregate–mortar interface, and rubber–mortar interface on the mesoscale. To simulate the entire process of concrete with varying PVA rubber/content from integrity to damage and cracking, a meso-numerical model of PVA rubber/concrete was constructed. The simulation results and test results are in good agreement, demonstrating the validity of the mesomodel and offering a theoretical foundation for the structural analysis and design of this type of concrete.

Selective arterial embolization of renal angiomyolipoma: comparing ethanol-lipiodol emulsion and polyvinyl alcohol particles as embolic agents.

To examine the effectiveness and safety of two embolic agents, an ethanol-lipiodol emulsion and polyvinyl alcohol (PVA) particles, for selective arterial embolization (SAE) of renal angiomyolipoma (AML). Retrospectively, we reviewed the medical records and imaging data of renal AML patients who received SAE in our hospitals between July 2007 and January 2018. Among those eligible for analysis were patients with complete medical information, preoperative and postoperative contrast-enhanced computed tomography scans, and follow-up data. An ethanol-lipiodol emulsion was used to embolize 15 AMLs, and PVA particles were used to embolize 16 AMLs. We compared the tumor responses and adverse events between the two embolization-agent groups. After embolization, no significant differences were observed in the shrinkage rates: 34.2% ± 3.4% for the ethanol-lipiodol emulsion group and 26.3% ± 3.0% for the PVA particles group (P = 0.090). Minor post-embolization complications were also similar between the groups, and there were no severe adverse events. The length of hospital stay after SAE was 2.5 ± 0.5 days for the ethanol-lipiodol emulsion group and 1.9 ± 0.5 days for the PVA particles group and was not significantly different (P = 0.425). The results showed that SAE with ethanol-lipiodol emulsion or PVA particles was safe and efficient in decreasing tumor size and controlling renal AML hemorrhage.

Helical coils augment embolization of the middle meningeal artery for treatment of chronic subdural hematoma: A technical note.

Embolization of the middle meningeal artery (MMA) is a safe and effective adjunct in the treatment of chronic subdural hematoma. While prior authors describe the use of coils to assist embolization by preventing reflux through eloquent collaterals, we de- scribe the use of coils to further open the MMA, allowing the administration of greater amounts of embolisate for a more robust embolization. The objective of this study was to demonstrate that helical coils can safely open the MMA following the administration of polyvinyl alcohol (PVA) particles. This allows for more embolisate to be administered into the MMA for more effective treatment. A retrospective review was conducted at our institution including intraoperative images and postoperative clinical and radiographic follow up. Failure rates using MMA embolization with PVA and helical coil augmentation were compared to failure rates in the literature of MMA embolization with PVA or ethylene vinyl-alcohol copolymer alone. A total of 8 cases were reviewed in which this technique was implemented. There were no immediate complications after treatment. All patients that underwent helical coil embolization following the administration of PVA had increased amount of embolisate delivered into the MMA. All patients at follow up had resolution of the subdural hematoma on outpatient imaging. Helical coil embolization allows for more embolisate administration into the MMA and provides a technical advantage for patients that fail traditional techniques of embolization. Case series are taking place to further test this hypothesis and identify the ideal patient population that may gain maximal yield from this novel technique.

Preoperative embolization of juvenile nasopharyngeal angiofibroma using medium to large size particles

Introduction. Juvenile nasopharyngeal angiofibroma are benign tumors, with locally aggressive behavior. Preoperative tumor embolization with polyvinyl alcohol particles can reduce intraoperative blood loss and facilitate surgical resection. Case outline. A 16-year-old male was admitted to hospital due to profuse epistaxis and sense of nose fullness. Multidetector computed tomographic angiography examination showed a tumor mass in the right nasal cavity with extension to the right maxillary sinus and ethmoidal cells on the right, and in the left nasal cavity. It rested on the nasal septum, but without bone destruction. After application of contrast agent, described mass became intensely opacified. Preprocedural digital subtraction angiography of external and internal carotid arteries of both sides showed extensive pathological vascularization, which received main contribution from branches of maxillary artery on right and, to a lesser extent, on left side. Due to danger of penetration of a particle embolization agent of smaller diameter into orbital branches and possible retrograde migration into carotid artery, we decided to apply particle embolization agent of larger diameter (500?700 ?m) than prescribed by modern standards. Tumor was completely surgically removed third day after embolization, and patient was discharged without any neurological deficit. Control contrast enhanced multidetector computed tomographic angiographies were performed at third and seventh month after surgery and showed no tumor residue or recurrence. Conclusion. The use of particles of larger diameter gave satisfactory results during operation ? surgical excision of tumor, when dangerous anastomoses do not allow use of particles of smaller diameter and can be safely performed without significant neurological nor systemic complications.

Onyx Versus Particles for Middle Meningeal Artery Embolization in Chronic Subdural Hematoma.

Middle meningeal artery (MMA) embolization has recently emerged as a treatment option for chronic subdural hematoma (cSDH). It is considered a simple and potentially safe endovascular procedure. To compare between 2 different embolic agents; onyx (ethylene vinyl alcohol) and emboparticles (polyvinyl alcohol particles-PVA) for endovascular treatment of cSDH. A retrospective analysis of all patients who underwent MMA embolization for cSDH treatment in 2 comprehensive centers between August 2018 and December 2021. Primary outcomes were failure of embolization and need for rescue surgical evacuation. Among 97 MMA embolizations, 49 (50.5%) received onyx and 48 (49.5%) received PVA. The presence of acute or subacute on cSDH was higher in the PVA group 11/49 (22.5%) vs 30/48 (62.5%), respectively, P < .001. There were no significant differences between both groups regarding failure of embolization 6/49 (12.2%) vs 12/48 (25.0%), respectively, P = .112, and need of unplanned rescue surgical evacuation 5/49 (10.2%) vs 8/48 (16.7%), respectively, P = .354. Hematoma thickness at late follow-up was significantly smaller in the PVA group 7.8 mm vs 4.6 mm, respectively; P = .017. Both onyx and PVA as embolic agents for cSDH can be used safely and have comparable clinical and surgical outcomes.

Transcatheter Arterial Embolization Combined with Anti-vascular Agent Combretastatin A4 Phosphate Inhibits Growth and Vascularization of Liver Tumor in an Animal Model.

This study aimed to investigate the effect of combretastatin A4 phosphate (CA4P) on proliferation, migration, and capillary tube formation of human umbilical vein endothelial cells (HUVECs) and the efficacy of transcatheter arterial embolization combined with CA4P in the treatment of rabbit VX2 liver tumor. The effects of different concentrations of CA4P on proliferation, migration and capillary tube formation of HUVECs were investigated by cell proliferation assay, wound healing assay and capillary tube formation assay, respectively. Thirty-two rabbits implanted with liver VX2 tumors were randomly divided into 4 groups. After catheterization of the left hepatic artery, the infusion was performed using normal saline (group A), CA4P aqueous solution (group B), lipiodol and polyvinyl alcohol particles (group C), and CA4P lipiodol emulsion and polyvinyl alcohol particles (group D), respectively. Half of the animals in each group were euthanized for immunohistochemical analysis to evaluate microvessel density (MVD) at 3 days post-treatment. The other half were examined by MRI and histology to evaluate tumor growth and necrosis at 7 days post-treatment. CA4P could inhibit the proliferation, migration, and tube formation of HUVECs in cell experiments. After interventional treatment, the level of MVD in group D was lower than that in group C (P<0.01). The tumor volume in group C or D was lower than that in group A or B (P<0.01). The tumor necrosis rate was higher in group D than in the other groups. The study suggests that CA4P could inhibit the proliferation, migration, and capillary tube formation of HUVECs, and transcatheter arterial embolization combined with CA4P could inhibit the growth of VX2 tumor and obviously induce tumor necrosis.