Ischemic effects of transcatheter arterial embolization with N-butyl cyanoacrylate-lipiodol on the colon in a Swine model

Cardiovasc Intervent Radiol. 2010 Oct;33(5):1009-15. doi: 10.1007/s00270-010-9867-1. Epub 2010 Apr 30.

Abstract

This study was designed to assess the safety of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate-lipiodol (NBCA-Lp) for the large bowel and to investigate the vital response to NBCA-Lp in a swine model. In nine swine, nine arteries nourishing the colon were embolized with NBCA-Lp (1 ml of NBCA mixed with 4 ml of lipiodol): sigmoid-rectal branch artery in six swine, right colic branch artery in two, and middle colic branch artery in one. The amount of NBCA-Lp was 0.1-0.4 ml. Sacrifice was conducted 3 days after TAE to identify histological infarction. Classification was conducted retrospectively: group A, vasa recta without NBCA-Lp embolization despite TAE; group B, three or fewer vasa recta with NBCA-Lp embolization; and group C, five or more vasa recta with NBCA-Lp embolization. In one swine in group A, no necrotic focus was observed. In group B, three of four swine experienced no ischemic damage. The remaining one swine experienced necrosis of mucosal and submucosal layers in one-fourth of the circumference. In group C, all four swine with marginal artery and five vasa recta or more embolized experienced total necrosis of mucosa, submucosa, and smooth muscle layers of the whole colonic circumference. Significant difference on the extent of ischemic damage was observed between groups B and C (P < 0.05). Microscopically, NBCA-Lp induced acute vasculitis. Embolization of three or fewer vasa recta with NBCA-Lp induced no ischemic damage or limited necrosis, whereas embolization of five or more vasa recta with NBCA-Lp induced extensive necrosis.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Biopsy, Needle
  • Catheterization / methods
  • Colon / blood supply*
  • Colon / pathology
  • Colon, Sigmoid / blood supply
  • Colon, Sigmoid / pathology
  • Disease Models, Animal
  • Embolization, Therapeutic / adverse effects*
  • Embolization, Therapeutic / methods
  • Enbucrilate / adverse effects
  • Enbucrilate / pharmacology*
  • Female
  • Immunohistochemistry
  • Ischemia / etiology
  • Ischemia / pathology
  • Mesenteric Artery, Superior / drug effects
  • Mesenteric Artery, Superior / pathology*
  • Probability
  • Random Allocation
  • Rectum / blood supply
  • Rectum / pathology
  • Risk Assessment
  • Statistics, Nonparametric
  • Swine

Substances

  • Enbucrilate