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Experimental Liver Embolization with Four Different Spherical Embolic Materials: Impact on Inflammatory Tissue and Foreign Body Reaction

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Abstract

We sought to describe and compare material specific inflammatory and foreign body reactions after porcine liver embolization with spherical embolic agents. In 40 animals, superselective liver embolization was performed with four different spherical embolic agents of various sizes: 40–120 μm (Embozene, Embosphere), and 100–300 μm, 500–700 μm, and 700–900 μm (Embozene, Embosphere, Bead Block, and Contour SE, respectively). After 4 or 12 weeks, inflammatory reactions were evaluated microscopically according to the Banff 97 classification. For investigation of foreign body reactions, a newly designed giant cell score was applied. Banff 97 and giant cell scores closely correlated. At 4 weeks, small Embosphere particles (100–300 μm) had a significantly higher Banff 97 score than Embozene, Bead Block, and Contour SE of the corresponding size. After 12 weeks, the calculated differences were not statistically significant. Comparison between the 4-week results and the 12-week results revealed a statistically higher Banff 97 score for Embosphere 100–300 μm after 4 weeks than after 12 weeks (P = 0.02). The overall foreign body reaction was pronounced after embolization with smaller particles, especially in small Embosphere particles. Giant cell numbers with Embosphere 100–300 μm were statistically higher compared with the other materials of corresponding size (P < 0.0001). Inflammatory and giant cell reactions after embolization procedures depend on the embolic material. The overall inflammatory reaction was low. However, marked inflammation was associated with small Embosphere particles at 4 weeks, a finding that might be caused by the allogeneic overcoat. Correspondingly, giant cells indicating a foreign body reaction were more frequently associated with small particle sizes, especially after embolization with small Embosphere particles.

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Acknowledgments

This study was sponsored in part by CeloNova BioSciences Inc., Newnan, GA. Drs. Stampfl, Lopez, and Richter have had sponsored research agreements with CeloNova. Dr. Richter has a consultant agreement with CeloNova.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University of Heidelberg, INF 110, 69120, Heidelberg, Germany

    Ulrike Stampfl, Sibylle Stampfl, Nadine Bellemann, Christof-Matthias Sommer, Ruben Lopez-Benitez, Heidi Thierjung, Boris Radeleff & Goetz M. Richter

  2. Department of Pathology, University of Heidelberg, INF 110, 69120, Heidelberg, Germany

    Irina Berger

Authors
  1. Ulrike Stampfl
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  2. Sibylle Stampfl
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  3. Nadine Bellemann
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  4. Christof-Matthias Sommer
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  5. Ruben Lopez-Benitez
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  6. Heidi Thierjung
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  7. Boris Radeleff
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  8. Irina Berger
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  9. Goetz M. Richter
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Corresponding author

Correspondence to Goetz M. Richter.

Additional information

Ulrike Stampfl and Sibylle Stampfl contributed equally to this study.

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Stampfl, U., Stampfl, S., Bellemann, N. et al. Experimental Liver Embolization with Four Different Spherical Embolic Materials: Impact on Inflammatory Tissue and Foreign Body Reaction. Cardiovasc Intervent Radiol 32, 303–312 (2009). https://doi.org/10.1007/s00270-008-9495-1

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  • DOI: https://doi.org/10.1007/s00270-008-9495-1

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