Submit to Biomedicines Review for Biomedicines Propose a Special Issue

Journal Browser

Vascular Embolization: Present and Future

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Published Papers

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 12227

Share This Special Issue

Special Issue Editor

Prof. Dr. Romaric Loffroy

E-Mail Website
Guest Editor

Department of Vascular, Oncologic and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 14 Rue Gaffarel, BP 77908, CEDEX, 21079 Dijon, France
Interests: quantitative MRI of the liver; oncologic radiology; interventional radiology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Transcatheter endovascular embolization has gained acceptance over the last two decades as a minimally invasive therapeutic approach compared to surgery. Embolization is routinely used worldwide in the field of oncology and vascular diseases, alone or in combination with other treatments, in several indications, such as tumor devascularization, aneurysms, bleedings or emergencies to occlude vessels and treat patients. Different endovascular embolic agents have been developed and are currently available on the market. Vascular embolic agents may be particles or fluids that are released into the bloodstream through a catheter to mechanically and/or biologically occlude the target vessel, either temporarily or permanently. This definition excludes vessel-blocking agents or devices such as balloons and coils, which are positioned at the target site, as opposed to being released in the bloodstream. Each agent has its own characteristics, mechanisms of action, indications and modalities of use, and advantages and drawbacks. The use of embolization in clinical practice has exploded in recent years and requires a thorough understanding of the behavior (rheology and vascular topology) and biocompatibility of each agent. To improve the accuracy of targeting, we need new, more sophisticated, bioactive agents, which are currently being developed. This Special Issue aims to publish original and/or review articles covering the state of the art of embolization techniques and occluding agents, and future perspectives of targeted endovascular embolic materials in the field of interventional radiology. Clinical and preclinical or experimental studies are all welcome.

Prof. Dr. Romaric Loffroy
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Biomedicines is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

biomaterial in biomedical research
interventional radiology
embolization
cyanoacrylates
copolymers
peripheral endovascular applications

Published Papers (6 papers)

Download All Papers

Research

Jump to: Other

14 pages, 3294 KiB

Open AccessArticle

Long-Term Clinical Outcome of Abdomino-Thoracic Lymphatic Interventions of Traumatic and Non-Traumatic Lymphatic Leakage in Adults

by Lea C. Kaminski, Julia Wagenpfeil, Jens Buermann, Philipp L. Lutz, Julian A. Luetkens, Ulrike I. Attenberger, Christian P. Strassburg, Jörg C. Kalff, Hans H. Schild and Claus C. Pieper

Biomedicines 2023, 11(9), 2556; https://doi.org/10.3390/biomedicines11092556 - 18 Sep 2023

Cited by 2 | Viewed by 798

Abstract

The aim of this study was to retrospectively evaluate the long-term results of lymphatic interventions in adults with abdomino-thoracic lymphatic pathologies. Management of abdomino-thoracic chylous effusions in adults undergoing X-ray-lymphangiography with or without lymph-vessel embolization (LVE) from 2010–2018 was reviewed. Patients underwent lymphangiography alone when imaging showed normal findings or lymphatic obstruction without leakage or reflux; otherwise, LVE was performed (leakage, reflux, obstruction with leakage or reflux, lymphatic masses). Technical and clinical success, complications, and long-term outcomes were assessed. 78 patients (47 male, median age 56.3 years) were treated for chylous effusions (60.3% traumatic, 39.7% non-traumatic). Lymphangiography showed leakage (48.7%), reflux (14.1%), obstruction (28.2%), lymphatic masses (5.1%), and normal findings (3.8%). Embolization was performed in 49/78 (62.8%) cases. Overall, treatment was clinically successful in 74.4% (mean follow-up of 28 months), with significant differences between LVE and lymphangiography (91.8% vs. 44.8%; p < 0.001), traumatic and non-traumatic etiologies (89.4% vs. 51.6%; p < 0.001), and leakage locations (p = 0.003). The clinical success of LVE did not differ between leakage etiologies or locations. Complications occurred in 5 patients (2/5 needed treatment). Patients survived significantly longer after successful treatment (2679 vs. 927 days; p = 0.044) and without malignancy (3214 vs. 1550 days; p = 0.043). Lymphatic interventions are safe and effective. LVE should be attempted whenever feasible, as success is high (>90%). Successful intervention has a positive effect on patient survival. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

13 pages, 9648 KiB

Open AccessArticle

Embolisation Using Microvascular Plugs for Peripheral Applications: Technical Results and Mid-Term Outcomes

by Rémy Mailli, Olivier Chevallier, Amin Mazit, Alexandre Malakhia, Nicolas Falvo and Romaric Loffroy

Biomedicines 2023, 11(8), 2172; https://doi.org/10.3390/biomedicines11082172 - 02 Aug 2023

Viewed by 770

Abstract

The Micro Vascular Plug^® (MVP, Medtronic) is a mechanical embolic agent available in small sizes that allows for distal embolisation. The objective of this retrospective observational single-centre study was to assess MVP embolisation procedures performed at a university hospital. The 33 patients who underwent MVP embolisation in 2021 were included (mean age, 64; 24 males and 9 females). The primary endpoint was technical success, which was defined as a full first-attempt occlusion with one or more MVPs, as documented on the end-of-procedure angiogram. In all patients, 51 MVPs were used overall, with other embolic agents in 23 of the 33 cases (usually coils and/or glue); 22 of the 33 procedures were emergent for bleeding and 11 were planned for other indications. Of the three technical failures, two were due to an angled target artery configuration precluding microcatheterisation and one to failure of the device to release from its wire. The technical success rate was thus 90.9%. No patient experienced MVP migration or other major complications. Five patients had recurrent clinical symptoms; in four cases, the cause was collateral development, and in one case, the cause was incomplete initial embolisation. No instances of recanalisation were documented during the short follow-up of 12 months, for a 100% secondary clinical success rate. At our tertiary-level centre, the MVP was both effective and safe for peripheral applications. Interventional radiologists should be conversant with the techniques and indications of MVP embolisation. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

12 pages, 1345 KiB

Open AccessArticle

In Vitro Evaluation of Acrylic Adhesives in Lymphatic Fluids-Influence of Glue Type and Procedural Parameters

by Daniel Kuetting, Patrick Kupczyk, Tatjana Dell, Julian A. Luetkens, Carsten Meyer, Ulrike I. Attenberger and Claus C. Pieper

Biomedicines 2022, 10(5), 1195; https://doi.org/10.3390/biomedicines10051195 - 21 May 2022

Cited by 2 | Viewed by 1315

Abstract

To evaluate the embolic properties of different acrylic adhesive/iodized oil mixtures for lymphatic interventions. Polymerization of histoacryl (HA) (Bayer Healthcare) and glubran 2 (GL) (GEM) mixed with iodized oil (ratios 1:0–1:7) were investigated in lymphatic fluids with low and high triglyceride (low TG & high TG) contents. Static polymerization time and dynamic polymerization experiments with different volumes of glucose flush (1, 2 and 5 mL) were performed to simulate thoracic duct embolization. For both glues, static polymerization times were longer when the iodized oil content was increased and when performed in high TG lymphatic fluid. In the dynamic experiments, the prolongation of polymerization due to the oil content and TG levels was less pronounced for both glue types. Increased lymphatic flow rates decreased embolization times for low glue/oil ratios while preventing embolization for high glue/oil ratios. Higher glucose flush volumes increased occlusion times. Polymerization times of acrylic glue in a lymphatic fluid are prolonged by increasing the iodized oil concentration and triglyceride concentration as well as by using larger volumes of glucose flush. Increased lymphatic flow rates decrease embolization times for low glue/oil ratios and may prevent embolization for high glue/oil ratios. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

11 pages, 2179 KiB

Open AccessArticle

Safety and Efficacy of Embolization with Microspheres in Chronic Refractory Inflammatory Shoulder Pain: A Pilot Monocentric Study on 15 Patients

by Emeric Gremen, Julien Frandon, Gabriel Lateur, Mathieu Finas, Mathieu Rodière, Clément Horteur, Michaël Benassayag, Frédéric Thony, Régis Pailhe and Julien Ghelfi

Biomedicines 2022, 10(4), 744; https://doi.org/10.3390/biomedicines10040744 - 22 Mar 2022

Cited by 12 | Viewed by 2855

Abstract

Purpose: Musculoskeletal (MSK) embolization is emerging in tendinopathy treatment. The objective of this study was to assess the efficacy and safety of MSK embolization with microspheres in the treatment of chronic shoulder pain. Patients and methods: This retrospective monocentric study included patients with chronic shoulder pain resistant to 6 months or more of conventional therapies who were treated with MSK embolization between 2017 and 2021. Embolization was performed using calibrated 100–250 µm microspheres. Clinical success was defined as pain reduction, i.e., a decrease in the visual analogue scale (VAS) pain score of ≥50% at 3 months after MSK embolization as compared to baseline. Adverse events were collected. Results: Fifteen patients (11 women, 4 men) were included, with a median age of 50.3 years (IQR: 46.7–54.5). The median duration of symptoms was 26.6 months (20.6–39.8). The median VAS pain scores were 7.0 (7.0–8.0) at baseline, 6.0 (3.5–7.0) at 1 month, 5.0 (4.5–6.5) and 5.0 (3.0–7.4) at 3 months and 6 months (p = 0.002). Three patients (20%) reported clinical success at 3 months. Three patients experienced minor complications after embolization (paresthesia, n = 2; transient osteo-medullary edema, n = 1) and two patients had moderate complications (transient skin ischemia). Conclusion: MSK embolization with microspheres for treatment of refractory chronic shoulder pain showed moderate results in terms of clinical success and safety. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

12 pages, 2771 KiB

Open AccessArticle

Collagenase-Induced Patellar Tendinopathy with Neovascularization: First Results towards a Piglet Model of Musculoskeletal Embolization

by Julien Ghelfi, Marylène Bacle, Olivier Stephanov, Hélène de Forges, Ian Soulairol, Pascal Roger, Gilbert R. Ferretti, Jean-Paul Beregi and Julien Frandon

Biomedicines 2022, 10(1), 2; https://doi.org/10.3390/biomedicines10010002 - 21 Dec 2021

Cited by 5 | Viewed by 3068

Abstract

Background: Therapeutic strategies targeting neovessels responsible for musculoskeletal chronic pain have emerged, including neovessels embolization. Our study aimed to develop a large animal model of patellar tendinopathy with neovascularization. Methods: Nine 3-month-old male piglets (18 patellar tendons) received percutaneous injections of increasing doses of collagenase (0 to 50 mg) at day 0 (D0). Tendinopathy was evaluated by ultrasound (D7 and D14). Neovascularization was evaluated visually and on angiographies. Bonar score was used for histological analysis (D14). Correlations were evaluated using Spearman’s rank (Rs) test. Results: Research protocol was well tolerated. All tendons were enlarged with a median increase of 31.58% [25–40.28] at D7 (p = 0.244) at D7 and 57.52% [48.41–91.45] at D14 (p = 0.065). Tendons with collagenase injection had more hypoechoic changes, with one tendon rupture (p = 0.012). Neovascularization was reported above 5 mg collagenase (p < 0.01) at D7 and D14 with dose-related neovessels induction (Rs = 0.8, p < 0.001). The Bonar score increased above 5 mg collagenase, correlated with the dose (Rs = 0.666, p = 0.003). Conclusions: The study shows the feasibility, safety and reproducibility of this new large animal model of patellar tendinopathy with neovascularization after collagenase injection. It will allow studying new treatments on direct embolization of neovessels by endovascular approach. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

Other

Jump to: Research

18 pages, 1160 KiB

Open AccessSystematic Review

Embolization for Type Ia Endoleak after EVAR for Abdominal Aortic Aneurysms: A Systematic Review of the Literature

by Elena Marchiori, Abdulhakim Ibrahim, Johannes Frederik Schäfers and Alexander Oberhuber

Biomedicines 2022, 10(6), 1442; https://doi.org/10.3390/biomedicines10061442 - 18 Jun 2022

Cited by 3 | Viewed by 2188

Abstract

(1) Successful endovascular repair for abdominal aortic aneurysms is based on the complete exclusion of the aneurysm sac from the systemic circulation. Type Ia endoleak (ELIA) is defined as the persistent perfusion of the aneurysm sac due to incomplete proximal sealing between aorta and endograft, with a consequent risk of rupture and death. Endoleak embolization has been sporadically reported as a viable treatment for ELIA. (2) A systematic literature search in PubMed of all publications in English about ELIA embolization was performed until February 2022. Research methods and reporting were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Data regarding patient numbers, technical success (endoleak absence at control angiography), reinterventions, clinical and imaging follow-up, and outcomes were collected and examined by two independent authors. (3) Twenty-one papers (12 original articles, 9 case reports) reported on 126 patients (age range 58–96 years) undergoing ELIA embolization 0–139 months after the index procedure. Indication for embolization was most often founded on unfavorable anatomy and patient comorbidities. Embolic agents used include liquid embolic agents, coils, plugs and combinations thereof. Technical success in this highly selected cohort ranged from 67–100%; the postprocedural complication rate within 30 days was 0–24%. ELIA recurrence was reported as 0–42.8%, with a secondary ELIA-embolization-intervention success rate of 50–100%. At a follow-up at 0–68 months, freedom from sac enlargement amounted to 76–100%, freedom from ELIA to 66.7–100%. (4) Specific literature about ELIA embolization is scant. ELIA embolization is a valuable bailout strategy for no-option patients; the immediate technical success rate is high and midterm and long-term outcomes are acceptable. Full article

(This article belongs to the Special Issue Vascular Embolization: Present and Future)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Vascular Embolization: Present and Future

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (6 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI