J Vasc Interv Radiol. 2023 Aug 25:S1051-0443(23)00635-8. doi: 10.1016/j.jvir.2023.08.024. Online ahead of print.
ABSTRACT
PURPOSE: To compare the mechanistic effects and hypertrophy outcomes using two different PVE regimens in normal and cirrhotic livers in a large animal model.
METHODS AND MATERIALS: The Institutional Animal Care and Use Committee (IACUC) approved all conducted experiments. Fourteen female Yorkshire pigs were separated into a cirrhotic (CG, n=7) and non-cirrhotic group (NCG, n=7); further subgrouped into using microspheres and coils (MC, n=3) or n-butyl-cyanoacrylate (NBCA, n=3) and their corresponding controls (each n=1). A 3:1 ethiodized-oil and ethanol-mixture was administered intraarterially in the CG to induce cirrhosis four-weeks before PVE. Animals received baseline-CT, PVE including pre- and post-PVE pressure-measurements and CT-imaging two and four-weeks post-PVE. Immunofluorescence staining’s for CD3, CD16, Ki-67 and Caspase-3 were conducted to assess immune-cell infiltration, hepatocyte-proliferation and apoptosis. Statistical significance was tested using Student’s t-test.
RESULTS: Four-weeks post-PVE, the FLR% increased by 18.82% (SD:3.55%) vs. 10.93% (SD:0.95% (p<0.01) in the NCG vs. CG. Control baseline sFLR% was 41.59% vs. 43.57%. Seperated by the embolic-agents the standardized FLR% (sFLR%) two-weeks post-PVE was 58.43% (SD:3.66%) and 52.24% (SD:0.88%) (p<0.01) for MC in the NCG vs. CG and 46.02% (SD:2.24%) and 47.24% (SD:0.40%) for NBCA, respectively. sFLR% four-weeks post-PVE was 60.48% (SD:3.88%) and 54.85% (SD:0.83%) (p<0.01), and 60.35% (SD:3.45%) and 54.15% (SD:0.95%) (p<0.01), respectively. Ki-67 signal intensity was increased in the embolized lobe both in the CG and NCG (p<0.01).
CONCLUSIONS: This pre-clinical study demonstratess that MC could be the preferred embolic of choice compared to NBCA when a substantial and rapid FLR increase is needed for resection, both in cirrhotic and non-cirrhotic liver.
PMID:37634850 | DOI:10.1016/j.jvir.2023.08.024
