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In Vivo Feasibility of Arterial Embolization with Permanent and Absorbable Suture: The FAIR-Embo Concept

  • V. VidalEmail author
  • J. F. HakEmail author
  • P. Brige
  • S. Chopinet
  • F. Tradi
  • M. Bobot
  • P. Gach
  • A. Haffner
  • G. Soulez
  • A. Jacquier
  • G. Moulin
  • J. M. Bartoli
  • B. Guillet
Laboratory Investigation Arterial Interventions
  • 25 Downloads
Part of the following topical collections:
  1. Arterial Interventions

Abstract

Purpose

Arterial embolization has been shown to be effective and safe for the management of bleeding, especially for postpartum and pelvic traumatic bleeding. We propose to evaluate the proof of concept of feasibility and effectiveness of arterial embolization with absorbable and non-absorbable sutures in a porcine model.

Materials and Methods

In the acute setting (n = 1), several different arteries (mesenteric, splenic, pharyngeal, kidney) were embolized using non-absorbable sutures (NAS): Mersutures braided sutures (polyethylene terephthalate). In the chronic setting (n = 3), only lower pole renal arteries were embolized. On the right side, NAS was used, whereas on the left side embolization was realized with absorbable suture (AS): Vicryl® braided suture (polyglactin 910). The chronic group was followed for 3 months. The pigs received contrast-enhanced CT the day before embolization (D-1), after the embolization (D0), at 1 month and 3 months after embolization (M1 and M3); digital subtraction angiography (DSA) was done at D0 and M3 and histological analysis at M3.

Results

All vascular targets were effectively embolized without any pre- or postoperative complications. Both DSAs and CTs at M3 showed a 100% recanalization rate for the AS embolization and a partial reversal rate for the NAS embolization. A renal hypotrophy in the embolized region was observed during both the M1 and M3 scans for both sutures (AS and NAS) with a clear hypotrophy for the NAS embolized kidney.

Conclusion

Embolization by AS and NAS (FAIR-Embo) is a feasible and effective treatment which opens up the possibility of global use of this inexpensive and widely available embolization agent.

Keywords

Embolization Absorbable suture Non-absorbable suture Life-threatening bleeding Emerging countries 

Abbreviations

CT

Computed tomography

NAS

Non-absorbable suture

AS

Absorbable suture

DSA

Digital subtraction angiography

Fr

French

Mm

Millimetre

Mg

Milligram

IMDs

Implantable medical devices

VR

Volume Rendering

Notes

Acknowledgements

My sincere thanks to Pr. Jafar Golzarian who, through our many friendly discussions, indirectly inspired me to do this study.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving animals were in accordance with the ethical standards of the institution or practice at which the studies were conducted.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2019

Authors and Affiliations

  • V. Vidal
    • 1
    • 2
    • 3
    Email author
  • J. F. Hak
    • 1
    • 2
    • 3
    Email author
  • P. Brige
    • 2
    • 3
  • S. Chopinet
    • 2
    • 3
    • 4
  • F. Tradi
    • 1
    • 2
    • 3
  • M. Bobot
    • 3
    • 5
    • 6
  • P. Gach
    • 1
    • 2
    • 3
  • A. Haffner
    • 7
  • G. Soulez
    • 8
  • A. Jacquier
    • 1
  • G. Moulin
    • 1
  • J. M. Bartoli
    • 1
  • B. Guillet
    • 3
    • 6
    • 9
  1. 1.Interventional Radiology Section, Department of Medical ImagingUniversity Hospital Timone APHMMarseilleFrance
  2. 2.LIIEAix Marseille UnivMarseilleFrance
  3. 3.CERIMEDAix Marseille UnivMarseilleFrance
  4. 4.Department of Digestive SurgeryUniversity Hospital Timone APHMMarseilleFrance
  5. 5.Department of NephrologyUniversity Hospital Conception APHMMarseilleFrance
  6. 6.INSERM 1263, INRA 1260, C2VNAix Marseille UnivMarseilleFrance
  7. 7.Department of Pathological AnatomyUniversity Hospital Timone APHMMarseilleFrance
  8. 8.Department of RadiologyCentre Hospitalier de l’Université de MontréalMontrealCanada
  9. 9.Department of RadiopharmacyAPHMMarseilleFrance

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