可注射原位凝胶栓塞剂的研究进展

Research progress of injectable in situ hydrogel embolic agents

血管栓塞术是临床介入治疗动脉瘤、动静脉畸形和实体瘤等疾病的常用手段,栓塞剂是影响栓塞疗效的重要因素。目前有线圈、微球和Onyx等数种栓塞剂进入临床应用,但仍存在一些治疗局限:如血管穿透能力弱、易于聚集、机械性能差、黏附导管及有毒溶剂参与等。近年来,大量研究发现原位凝胶在血管栓塞领域具有良好的应用前景,其低黏度前体溶液注射到靶向血管后,可通过物理交联和/或化学交联发生溶胶-凝胶转变等形成水凝胶阻断血流,并具有优异的载药缓释性能。本文汇总了近10年来可注射的原位凝胶血管栓塞剂的研究进展,并对其发展前景进行讨论,以期为未来新型栓塞剂的开发提供参考。

Embolotherapy is a common method for clinical intervention in the treatment of diseases including aneurysms, arteriovenous malformations and solid tumors, and embolic agents are a decisive factor affecting the effect of embolization. Although various embolic agents like coils, microspheres, and Onyx have been used clinically, there are still some treatment limitations: such as weak blood vessel penetration, easy to aggregate, poor mechanical properties, adhesion to catheters, and the need for toxic solvents(e. g. dimethyl sulfoxide). In recent years, a number of studies have found that in situ hydrogels have good application prospects in the field of vascular embolization. When low viscosity precursor solution is injected into the targeted blood vessel via microcatheters, it will undergo a sol-gel transition through physical and/or chemical cross-linking to form hydrogel to block blood flow. In addition, these in situ hydrogels can load drugs by pore embedding, electrostatic interaction, chemical bonding, etc., and have excellent sustained-release properties. This review summarizes the research progress of injectable in situ hydrogel vascular embolic agents in the past ten years, with a view to provide references for the development of new embolic agents in the future.