Combination of Alcohol and EVOH as a New Embolic Agent: Midterm Tissue and Inflammatory Effects in a Swine Model

• Main Authors: Jean-François Hak, Farouk Tradi, Mickael Bobot, Pauline Brige, Paul Habert, Sophie Chopinet, Aurélie Haffner, Gilles Soulez, Benjamin Guillet, Vincent Vidal
• Format: Article
• Language: English
• Published: Hindawi Limited 2020-01-01
• Series: Radiology Research and Practice
• Online Access: http://dx.doi.org/10.1155/2020/8831060

Objective. To evaluate the vascular occlusion and midterm tissue toxicity properties of a combination of ethylene-vinyl alcohol (EVOH) (Squid 18®) (75%) and alcohol (25%)—Alco-Squid 18—in a swine model. Materials and Methods. Alco-Squid 18 (75% Squid 18® mixed with 25% alcohol) (AS18) was compared to embolization with 96% alcohol alone and to embolization with Squid 18® (S18®) alone. An arteriovenous malformation (AVM) model was created in group 1 (n = 2). Each AVM model was then embolized with AS18 or S18® alone with evaluation of a ratio between the volume of embolic agent divided by the volume of the AVM (evaluated by CT). For group 2 (n = 5), each agent was tested on three different kidneys (upper pole kidney artery). Pre- and postinterventional CTs, angiographies, blood alcohol content dosages, and histological studies (3 months postintervention) were performed. Results. AS18 has better distal distribution than S18® alone, both in the kidneys (mean capsule-S18® distance: 3.9 mm (±0.23) and mean capsule-AS18 distance: 2.3 mm (±0.11) (p=0.029) and in the AVM model. Histological exploration found a higher rate of tubular necrosis with AS18 compared with S18® alone and alcohol alone (3.78 ± 0.44 compared to 2.33 ± 1.22 p = 0.012 and 1.22 ± 0.67 p <0 .0001). The blood alcohol content was negligible in all cases. Conclusion. AS18 can suggest a better distal sclerotic and embolic character as compared with S18® alone without systemic toxicity.