Renal Artery Embolization Using a New Liquid Embolic Material Obtained by Partial Hydrolysis of Polyvinyl Acetate (Embol): Initial Experience in Six Patients

Abstract

ObjectiveTo evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery.Materials and MethodsEmbol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed.ResultsThe six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension.ConclusionEmbol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

Transarterial Embolization

“…For complete renal embolization, 0.2 ml/kg body weight of absolute ethanol (99% ethyl alcohol) is typically perfused in a mixture with non-ionic contrast material for appropriate control under fluoroscopy (Park et al. 1994;Park et al 2000). Vascular occlusion induced by the ethanol is more peripheral than most other agents (Latschaw1985).…”

“…A new liquid embolic material obtained by partial hydrolysis of polyvinyl acetate has been used recently (Park et al 2000).…”

“…For successful renal TAE, both selection of appropriate selective or super-selective catheterization and adequate operator experience are required. To occlude the main renal artery proximally, some authors recommend balloon-assisted occlusion to exclude potential reflux, particularly when liquid embolic materials are used (Park et al 2000). When the target vessels are distal to segmental arteries, a super-selective approach with the use of a microcatheter should be favored.…”

Polyvinyl Acetate

“…1 The Expert Panel reviewed newly available studies since that assessment along with updated frequency and concentration of use information. [2][3][4][5][6][7][8][9][10][11] The Expert Panel confirmed that polyvinyl acetate is safe in the present practices of use and concentration given in Table 1 and did not reopen this safety assessment.…”