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New Alcohol and Onyx Mixture for Embolization: Feasibility and Proof of Concept in Both In Vitro and In Vivo Models

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Abstract

Introduction

Onyx and ethanol are well-known embolic and sclerotic agents that are frequently used in embolization. These agents present advantages and disadvantages regarding visibility, injection control and penetration depth. Mixing both products might yield a new product with different characteristics. The aim of this study is to evaluate the injectability, radiopacity, and mechanical and occlusive properties of different mixtures of Onyx 18 and ethanol in vitro and in vivo (in a swine model).

Materials and Methods

Various Onyx 18 and ethanol formulations were prepared and tested in vitro for their injectability, solidification rate and shrinkage, cohesion and occlusive properties. In vivo tests were performed using 3 swine. Ease of injection, radiopacity, cohesiveness and penetration were analyzed using fluoroscopy and high-resolution CT.

Results

All mixtures were easy to inject through a microcatheter with no resistance or blockage in vitro and in vivo. The 50%-ethanol mixture showed delayed copolymerization with fragmentation and proximal occlusion. The 75%-ethanol mixture showed poor radiopacity in vivo and was not tested in vitro. The 25%-ethanol mixture showed good occlusive properties and accepted penetration and radiopacity.

Conclusion

Mixing Onyx and ethanol is feasible. The mixture of 25% of ethanol and 75% of Onyx 18 could be a new sclero-embolic agent. Further research is needed to study the chemical changes of the mixture, to confirm the significance of the added sclerotic effect and to find out the ideal mixture percentages.

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Authors and Affiliations

  1. Hôpital cardiologique, Centre Hospitalier Universitaire (CHRU) de Lille, Boulevard Jules LECLERQ, 59037, Lille, France

    Mohammad Saeed Kilani & Vincent Vidal

  2. Experimental Interventional Imaging Laboratory, CERIMED, Marseilles, France

    Mohammad Saeed Kilani

  3. Department of Mechanical Engineering, école de technologie supérieure (ETS) & CHUM Research center (CRCHUM), Montreal, Canada

    Fatemeh Zehtabi & Sophie Lerouge

  4. Department of Radiology, Centre Hospitalier de l’Université de Montréal, 1560 Sherbrooke East, H2L 4M1, Montreal, Canada

    Gilles Soulez

  5. Department of Radiology, Radio-Oncology and Nuclear Medicine, University of Montreal, Montreal, Canada

    Gilles Soulez

  6. Department of Medical Imaging, University Hospital Timone, Marseilles, France

    Jean Michel Bartoli

  7. Aix-Marseille University, Marseille, France

    Vincent Vidal

  8. Interventional Radiology Section, Department of Medical Imaging, University Hospital TIMONE, Marseille, France

    Vincent Vidal

  9. Radiology Department, King Faisal Specialist Hospital and Research Center, MBC 28, PO Box 3354, Riyadh, 11211, Saudi Arabia

    Mohammad F. Badran

Authors
  1. Mohammad Saeed Kilani
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  2. Fatemeh Zehtabi
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  3. Sophie Lerouge
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  4. Gilles Soulez
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  5. Jean Michel Bartoli
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  6. Vincent Vidal
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  7. Mohammad F. Badran
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Corresponding author

Correspondence to Mohammad Saeed Kilani.

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Conflict of interest

Gilles Soulez: Dr. Soulez reports grants from Cook Medical, grants from Biotronik Medical, from Siemens Medical, outside the submitted work; in addition, Dr. Soulez has a patent null licensed to Cook Medical.

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Fatemeh Zehtabi: Co-first author

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Saeed Kilani, M., Zehtabi, F., Lerouge, S. et al. New Alcohol and Onyx Mixture for Embolization: Feasibility and Proof of Concept in Both In Vitro and In Vivo Models. Cardiovasc Intervent Radiol 40, 735–743 (2017). https://doi.org/10.1007/s00270-016-1559-z

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  • DOI: https://doi.org/10.1007/s00270-016-1559-z

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