Ablation of renal tumors with absolute ethanol: a new technique.

Ellman, BA; Parkhill, Billy J.; Curry, Thomas S.; Marcus, Peter B.; Peters, Paul C.

doi:10.1148/radiology.141.3.7302214

Cited by 172 publications

(57 citation statements)

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“…A small amount of ethanol was contained as a solvent in the embolic material and a small amount of 30% ethanol was injected immediately before the EVAL/ethanol mixture injection in this study. However, no definite changes typically seen in ethanol embolization such as severe endothelial damages or perivascular inflammatory changes were observed, as also reported by Hamada et al (14,21). Therefore, the embolic effect of ethanol in this study was considered to be minimal.…”

Section: Histopathological Analysissupporting

confidence: 63%

“…As a fluid embolic agent, absolute ethanol has also been used in TAE for the treatment of some renal conditions, arteriovenous malformations and other pathologies in clinical practice (21,22). It may also flow into the portal veins and hepatic sinusoids following injection into the hepatic artery and damage them, resulting in hepatic segmental infarction.…”

Section: Histopathological Analysismentioning

confidence: 99%

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Forcible Intraarterial Injection of a Nonadhesive Liquid Embolic Agent under Microballoon Occlusion: Experimental Study in Swine Liver

Ogi

Matsui

Sanada

et al. 2014

Journal of Vascular and Interventional Radiology

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PURPOSE: To evaluate the feasibility and effectiveness of transcatheter embolization by forcible intra-arterial injection of ethylene vinyl alcohol copolymer (EVAL)/ethanol mixture under microballoon occlusion in comparison with conventional transcatheter arterial embolization methods in non-tumoral swine liver. MATERIALS AND METHODS: Nine swine were divided into three groups: embolization with EVAL/ethanol mixture (EVAL group, n=5), with ethiodized oil (ethiodized oil group, n=2) and with microspheres (microspheres group, n=2). Embolization was performed at the subsegmental hepatic artery. EVAL/ethanol mixture was injected forcibly through a microcatheter with a balloon, which was inflated to prevent backflow of the mixture during the injection. Ethiodized oil or microspheres were injected into the artery using a microcatheter without balloon occlusion. Two animals of the EVAL group were euthanized immediately after embolization, and the distribution of EVAL was assessed microscopically. The remaining seven animals were euthanized four weeks after embolization, and the histopathological changes were assessed. RESULTS: All procedures were technically successful. EVAL occupied greater than 80% of the embolized hepatic arterial, portal venous and sinusoidal lumens. Four weeks after embolization, ischemic coagulation necrosis was observed in the EVAL group. In the ethiodized oil and microspheres groups, parenchymal necrosis was not observed. CONCLUSION: Transcatheter embolization by forcible intra-arterial injection of EVAL/ethanol mixture under micro-balloon occlusion was feasible and achieved the simultaneous embolization of hepatic artery, portal vein and sinusoids in swine liver, resulting in complete necrosis of the embolized segment.

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Section: Histopathological Analysissupporting

confidence: 63%

Section: Histopathological Analysismentioning

confidence: 99%

Forcible Intraarterial Injection of a Nonadhesive Liquid Embolic Agent under Microballoon Occlusion: Experimental Study in Swine Liver

Ogi

Matsui

Sanada

et al. 2014

Journal of Vascular and Interventional Radiology

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“…Iohexol-ethanol solution was employed for the treatment of hydronephrosis because it is easy to deliver through small catheters. Also, it is inexpensive, easy to handle, and it provides complete infarction with both cellular death and secondary vascular thrombus without evidence of collateralization, and shows a low risk of complications such as reflux to other organs [8,9].…”

Section: Discussionmentioning

confidence: 99%

Application of Transarterial Embolization of Renal Artery in Rabbits with Experimental Hydronephrosis.

Chang

Seo

Choi

et al. 2002

The Journal of Veterinary Medical Science

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ABSTRACT. This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) using iohexolethanol solution in rabbits with unilateral experimental hydronephrosis and to evaluate the embolized kidney and contralateral normal kidney using B-mode ultrasonography and color Doppler ultrasonography. Experimental hydronephrosis was induced at 17 days after ligation of unilateral ureter in 13 rabbits. Renal artery embolization was performed using selective catheterization in the hyd ronephrotic kidney of eight rabbits and electrocardiography, oxygen saturation, body temperature, pulse, and respiratory rate were within normal ranges during procedures. Iohexol-ethanol solution was used as embolic material. Average ethanol dose for renal artery embolization was 1.4 ± 0.7 ml/kg. There were no rabbits expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. In color Doppler ultrasonographic findings, there was no blood flow into the embolized kidneys treated by TAE-RA, how ever, blood flow signal was found in hydronephrotic kidney not treated by TAE-RA. Ultrasonographically, the mean longitudinal length of the embolized kidney significantly decreased at 2 and 3 months after TAE-RA. No significant difference of resistive index values was found between contralateral normal kidney of rabbits treated by TAE-RA and contralateral normal kidneys of rabbits treated with nephrectomy. We may conclude that TAE-RA with iohexol-ethanol solution is a viable alternative to nephrectomy in rabbits with unilateral hydronephrosis. KEY WORDS: color Doppler ultrasonography, hydronephrosis, iohexol-ethanol, rabbit, renal artery embolization.

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“…For this reason, an effective and safer intraoperative hemostatic approach is needed to improve the short and long-term prognosis of patients with intracranial tumors (27). Ethyl alcohol (EA) has been extensively used as a successful sclerosing agent for interventional therapy of many disorders, including malignancies such as intraabdominal tumors and endocrine system tumors (2,4,(7)(8)(9)12,13,17,18). It is easily accessible, biocompatible, and less toxic if carefully used (11,12,18,27).…”

Section: █ Introductionmentioning

confidence: 99%

Intratumoral ethyl alcohol injection for devascularization of hypervascular intracranial tumors

Tümtürk

Küçük²,

Canöz³

et al. 2015

Turkish Neurosurgery

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Pre-operative endovascular embolization of tumor feeders with various embolic agents is a widely accepted method (3,6,18). The purpose of embolization is not only to occlude the vascular supply to the tumor, to achieve tumor necrosis and to decrease intraoperative blood loss, but also to maintain better visualization of surgical fields, which decreases the risk of adjacent tissue destruction and tumor recurrence (3). However, cases requiring emergent surgical intervention and tumors with feeders that also supply important normal anatomical structures may limit utilization of preoperative embolization (6,18). Additionally, there may be some cases that undergo surgery in which massive bleeding during surgery is not expected. Consequently, reducing intratumoral blood flow or at least decreasing it to a more acceptable level █ INTRODUCTION A safe and effective resection of intracranial tumors depends on meticulous homeostasis (11,18,27). Brain tumors with rich vascular structures and deeply seated feeding arteries running at the opposite site of the surgical field may cause dangerous bleeding problems, which are likely to result in higher mortality and morbidity. The control of bleeding is usually difficult and the surgical duration is longer (3,6,12). These unexpected and abrupt bleedings may not sometimes allow total excision of the tumor. Currently, the overall consensus within the field of neurosurgery is that preoperative tumor embolization is beneficial for reducing intraoperative blood loss in patients with vascular tumors (6,12).AIM: Hypervascular intracranial tumors may cause serious bleeding in surgery. Though pre-operative endovascular embolization of tumor is a widely accepted method, sometimes despite embolization, an effective and safer intraoperative hemostatic technique is needed to prevent or at least decrease the massive bleeding from the tumors. The aim of this study was to investigate the effect of the ethyl alcohol (EA) injection in hypervascular tumors and find out whether it is likely to be an alternative method to prevent massive bleeding from tumor. MATERIAL and METhODS:Fifty-five cases that had hypervascular intracranial tumor and underwent EA injections into their tumors were included in the study. A small amount (0.1-0.2 ml) of EA was used in every injection. Total EA amount differed from 1.2 to 18 ml for each patient. RESULTS:Most of the tumors were removed with less bleeding, because bleedings stopped or decreased during resection after EA injections. No serious complication that might be related to EA was observed. CONCLUSION:EA injection into the tumor is an easy, cheap and less invasive method to obtain effective and safe tumor devascularization. It may be an alternative method for tumor devascularization when preoperative embolization cannot be performed due to any reason or severe bleeding despite embolization.

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Ablation of renal tumors with absolute ethanol: a new technique.

Cited by 172 publications

References 0 publications

Forcible Intraarterial Injection of a Nonadhesive Liquid Embolic Agent under Microballoon Occlusion: Experimental Study in Swine Liver

Forcible Intraarterial Injection of a Nonadhesive Liquid Embolic Agent under Microballoon Occlusion: Experimental Study in Swine Liver

Application of Transarterial Embolization of Renal Artery in Rabbits with Experimental Hydronephrosis.

Intratumoral ethyl alcohol injection for devascularization of hypervascular intracranial tumors

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