Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol): Initial Experience in Six Patients

  • Sung Il Park (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Do Yun Lee (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Jong Yoon Won (Department of Diagnostic Radiology, Yonsei University College of Medicine) ;
  • Sangsoo Park (Department of Biomedical Engineering, Seoul Health College)
  • Received : 1999.11.05
  • Accepted : 2000.07.31
  • Published : 2000.09.30
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Abstract

Objective: To evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery. Materials and Methods: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. Results: The six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension. Conclusion: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

Keywords

References

  1. Edling NP, Ovenfors CO. Interventional embolization in selective renal arteriography: an experimental study in dogs. Acta Radiol Diagn 1964;2:316-320  https://doi.org/10.1177/028418516400200406
  2. Kalman D, Varenhorst E. The role of arterial embolization in renal cell carcinoma. Scand J Urol Nephrol 1999;33:162-170  https://doi.org/10.1080/003655999750015934
  3. Sung KB, Park SS, Yoon HK et al. Study on effectiveness and safety of portal vein embolization using a new liquid embolic material (Embol-78-12) in pigs. J Korean Radiol Soc 1999;40:237-246  https://doi.org/10.3348/jkrs.1999.40.2.237
  4. Park SS, Yoon HK, Lee NS et al. Portal vein embolization with use of a new liquid embolic material: An experimental study. J Vasc Interv Radiol 1999;10:339-345  https://doi.org/10.1016/S1051-0443(99)70040-0
  5. Segni RD, Young AT, Qian Z, Castaneda-Zuniga WR. Embolotherapy: agents, equipment, and techniques. In Castaneda-Zuniga WR, Tadavarthy SM, Qian Z, Ferral H, Maynar M. Interventional radiology. Baltimore: Williams and Wilkins, 1997: 29-103 
  6. Lanigan D, Jurriaans E, Hammonds JC, Wells IP, Choa RG. The current status of embolization in renal cell carcinoma-A survey of local and national practice. Clin Radiol 1992;46:176-178  https://doi.org/10.1016/S0009-9260(05)80440-4
  7. Park JH, Kim SH, Han JK, Chung JW, Han MC. Transcatheter arterial embolization of unresectable renal cell carcinoma with a mixture of ethanol and iodized oil. Cardiovasc Intervent Radiol 1994;17:323-327  https://doi.org/10.1007/BF00203951
  8. Dickinson M, Ruckle H, Beaghler M, Hadley HR. Renal Angiomyolipoma: Optimal treatment based on size and symptoms. Clin Nephrol 1998;49:281-286 
  9. Lee W, Kim TS, Chung JW, Han JK, Kim SH, Park JH. Renal angiomyolipoma: Embolotherapy with a mixture of alcohol and iodized oil. J Vasc Interv Radiol 1998;9:255-261  https://doi.org/10.1016/S1051-0443(98)70266-0
  10. Perini S, Gordon RL, LaBerge JM et al. Transcatheter embolization of biopsy-related vascular injury in the transplanted kidney: Immediate and long-term outcome. J Vasc Interv Radiol 1998;9:1011-1019  https://doi.org/10.1016/S1051-0443(98)70442-7
  11. Phadke RV, Sawlani V, Rastogi H et al. Iatrogenic renal vascular injuries and their radiological management. Clin Radiol 1997;52: 119-123  https://doi.org/10.1016/S0009-9260(97)80104-3
  12. Beaujeux R, Saussine C, Al-Fakir A et al. Superselective endovascular treatment of renal vascular lesions. J Urol 1995;153:14-17  https://doi.org/10.1097/00005392-199501000-00007
  13. Sadato A, Taki W, Ikada Y et al. Experimental study and clinical use of polyvinyl acetate emulsion as liquid embolisation material. Neuroradiology 1994;36:634-641  https://doi.org/10.1007/BF00600429
  14. Hamada J, Ushio Y, Kazekawa K, Tsukahara T, Hashimoto N, Iwata H. Embolization with cellulose porous beads, I: An experimental study. Am J Neuroradiol 1996;17:1895-1899 
  15. Miller DL, Bacher JD, DVM, O Leary TJ, Maxwell M. Comparison of hot contrast material and hot saline for renal ablation in a canine model. Invest Radiol 1986;21:56-63  https://doi.org/10.1097/00004424-198601000-00010
  16. Irie T, Kusano S. Fragmented platinum microcoils as embolization material. Acta Radiol 1996;37:696-699  https://doi.org/10.3109/02841859609177702
  17. Lammer J, Justich E, Schreyer H, Pettek R. Complications of renal tumor embolization. Cardiovasc Intervent Radiol 1985;8:31-35 https://doi.org/10.1007/BF02552637