BACKGROUND While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization(cTACE),direct comparisons between these embolic agents are r...BACKGROUND While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization(cTACE),direct comparisons between these embolic agents are rare.AIM To compare the efficacy and safety of superselective cTACE using Embosphere®or Marine gel®in patients with early-stage hepatocellular carcinoma(HCC).METHODS This retrospective study included 70 patients with small(<4 cm)HCC who underwent cTACE with Embosphere®(n=33)or Marine gel®(n=37)as the embolic agent at a single center between March 2021 and July 2022.The radiologic images and clinical data were retrospectively reviewed,with an emphasis on tumor response,procedure-related complications,and local tumor recurrence.The primary index tumor was assessed on a 1-mo follow-up image,and local progression-free survival was obtained using the Kaplan-Meier method and was compared by the log-rank test.RESULTS The median tumor size of both groups was 1.5 cm,and 69 patients achieved a complete response one month after cTACE.The cumulative local recurrence rate at 12 mo was 15.5%in the Embosphere®group and 14.4%in the Marine gel®group.The local progression-free survival was not significantly different between the two groups(P=0.83).In the multivariate analysis,high serum alphafetoprotein was the only significant poor prognostic factor for local tumor progression(P=0.01).Postembolization syndrome occurred in 36.4%of the Embosphere®group and 35.1%of the Marine gel®group,and there were no cases of biloma,biliary duct dilation,or liver abscess in either group.CONCLUSION Calibrated gelatin sponge particles(Marine gel®)and calibrated microspheres(Embosphere®)have similar outcomes in terms of tumor response for superselective cTACE of small HCC.展开更多
Polyvinyl alcohol(PVA) embolization particles, currently used in clinical practice, have good expansibility and are capable of permanent embolization. However, the lack of adhesion of embolization particles contribute...Polyvinyl alcohol(PVA) embolization particles, currently used in clinical practice, have good expansibility and are capable of permanent embolization. However, the lack of adhesion of embolization particles contributes to facilitated recanalization after embolization, while the lack of visualization facilitates misembolization. At present, embolization materials with good expansion, adhesion, and visualization potential are urgently required in clinical practice. Here, we report the development of PVA/gelatin/iohexol(I) fiber blocks as a novel embolization material for liver embolization in rats. In our work, electrospun PVA/gelatin/I nanofibrous mats were first prepared, homogenized, centrifuged in a gradient manner, and freeze-dried to obtain fiber blocks(fiber diameter =296.2 ± 74.23 nm, length 99.6 ± 17.0 μm × width 46.9 ± 13.3 μm). The fiber blocks exhibited excellent cytocompatibility and hemocompatibility. Fiber blocks with a PVA/gelatin/I mass ratio of 8:2:10 were selected due to their excellent expansibility and adhesive properties. The PVA/gelatin/I fiber blocks display excellent liver embolic effects and computed tomography(CT) imaging potential due to a combination of the following characteristics: expansibility of PVA and gelatin, adhesive property of gelatin, and CT imaging potential of I. The developed fiber block material is an embolic material that may potentially be used in interventional medicine.展开更多
Calcium alginate gel(CAG) has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study...Calcium alginate gel(CAG) has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study,a regenerative embolic material was designed by seeding rat fibroblasts in a CAG.The study investigated the feasibility of constructing a 3-dimensional culture system.The fibroblasts grew well and firmly attached to the CAG.CAG was conducive for fibroblast growth,and resulted in a 3-dimensional culture system.Results show that CAG can be used theoretically as a vascular,regenerative,embolic material.展开更多
文摘BACKGROUND While gelatin sponge particles and calibrated microspheres are commonly used as embolic materials in conventional transarterial chemoembolization(cTACE),direct comparisons between these embolic agents are rare.AIM To compare the efficacy and safety of superselective cTACE using Embosphere®or Marine gel®in patients with early-stage hepatocellular carcinoma(HCC).METHODS This retrospective study included 70 patients with small(<4 cm)HCC who underwent cTACE with Embosphere®(n=33)or Marine gel®(n=37)as the embolic agent at a single center between March 2021 and July 2022.The radiologic images and clinical data were retrospectively reviewed,with an emphasis on tumor response,procedure-related complications,and local tumor recurrence.The primary index tumor was assessed on a 1-mo follow-up image,and local progression-free survival was obtained using the Kaplan-Meier method and was compared by the log-rank test.RESULTS The median tumor size of both groups was 1.5 cm,and 69 patients achieved a complete response one month after cTACE.The cumulative local recurrence rate at 12 mo was 15.5%in the Embosphere®group and 14.4%in the Marine gel®group.The local progression-free survival was not significantly different between the two groups(P=0.83).In the multivariate analysis,high serum alphafetoprotein was the only significant poor prognostic factor for local tumor progression(P=0.01).Postembolization syndrome occurred in 36.4%of the Embosphere®group and 35.1%of the Marine gel®group,and there were no cases of biloma,biliary duct dilation,or liver abscess in either group.CONCLUSION Calibrated gelatin sponge particles(Marine gel®)and calibrated microspheres(Embosphere®)have similar outcomes in terms of tumor response for superselective cTACE of small HCC.
基金the State Key Laboratory forModification of Chemical Fibers and Polymer Materials,Donghua Universitythe Science and Technology Commission of Shanghai Municipality(19XD1400100 and 20520710300)+1 种基金the 2019th Shanghai Medical Guide Science and Technology Supporting Project(19411971000)the Science and Technology Research Project from the Science and Technology Department of Henan Province in 2020(202102310539)。
文摘Polyvinyl alcohol(PVA) embolization particles, currently used in clinical practice, have good expansibility and are capable of permanent embolization. However, the lack of adhesion of embolization particles contributes to facilitated recanalization after embolization, while the lack of visualization facilitates misembolization. At present, embolization materials with good expansion, adhesion, and visualization potential are urgently required in clinical practice. Here, we report the development of PVA/gelatin/iohexol(I) fiber blocks as a novel embolization material for liver embolization in rats. In our work, electrospun PVA/gelatin/I nanofibrous mats were first prepared, homogenized, centrifuged in a gradient manner, and freeze-dried to obtain fiber blocks(fiber diameter =296.2 ± 74.23 nm, length 99.6 ± 17.0 μm × width 46.9 ± 13.3 μm). The fiber blocks exhibited excellent cytocompatibility and hemocompatibility. Fiber blocks with a PVA/gelatin/I mass ratio of 8:2:10 were selected due to their excellent expansibility and adhesive properties. The PVA/gelatin/I fiber blocks display excellent liver embolic effects and computed tomography(CT) imaging potential due to a combination of the following characteristics: expansibility of PVA and gelatin, adhesive property of gelatin, and CT imaging potential of I. The developed fiber block material is an embolic material that may potentially be used in interventional medicine.
文摘Calcium alginate gel(CAG) has been shown to successfully model aneurysm embolization within a short period of time.However,gradually degrading CAG potentially results in aneurysm recanaliza-tion.In the present study,a regenerative embolic material was designed by seeding rat fibroblasts in a CAG.The study investigated the feasibility of constructing a 3-dimensional culture system.The fibroblasts grew well and firmly attached to the CAG.CAG was conducive for fibroblast growth,and resulted in a 3-dimensional culture system.Results show that CAG can be used theoretically as a vascular,regenerative,embolic material.