Solid Tumor Embolotherapy in Hepatic Arteries with an Anti-reflux Catheter System

Abstract

Unresectable hepatoma accounts for the majority of malignant liver tumor cases for which embolization therapy is considered a viable treatment option. However, the potential risk of aberrant particle deposition in non-target regions could cause severe side-effects, alongside diminished efficacy. A computational model has been developed to analyze the particle-hemodynamics before and after deployment of an FDA-approved anti-reflux catheter. The catheter features a retractable, porous cone-like tip designed to allow forward blood flow while preventing microsphere reflux. A patient-specific hepatic artery system, with different daughter branches connected to a liver tumor, was chosen as a representative test bed. In vitro as well as in vivo measurements were used to validate the computer simulation model. The model captures the effect of tip-deployment on blood perfusion and pressure drop in an interactive manner under physiologically realistic conditions. A relationship between the pressure drop and embolization level was established, which can be used to provide clinicians with real-time information on the best infusion-stop point. However, the results show that the present procedure for embolization of downstream vessels which feed a tumor is quite arbitrary. Nevertheless, a method to recycle aberrant particles captured by the deployed tip was proposed to minimize side-effects.

End-hole Versus Microvalve Infusion Catheters in Patients Undergoing Drug-Eluting Microspheres-TACE for Solitary Hepatocellular Carcinoma Tumors: A Retrospective Analysis

“…The authors hypothesize that the MVI catheters demonstrated greater on-target microsphere deposition within the tumor and increased tumor percentage necrosis through three mechanisms. First, the expandable tip in the MVI catheter acts as a one-way valve that enables operators to preferentially target tumor tissue by eliminating reflux [23]. During TACE performed with EH microcatheters, the infusion is terminated when stasis is achieved.…”

Review of the Development of Methods for Characterization of Microspheres for Use in Embolotherapy: Translating Bench to Cathlab

“…A planar model of the human liver vasculature was also recently developed by Xu et al to study quantitative endpoints during embolization. Channel diameter ranged from 6 mm (celiac artery) down to 1 mm arterial branches, and physiological values of static pressure (70–150 mmHg) and flow rate (200–500 mL min −1 through the whole liver) were replicated using a homogeneous non‐Newtonian fluid.…”

Comprehensive analysis of common safety profiles and their predictive factors in 520 records of liver cancer patients treated by drug-eluting beads transarterial chemoembolization

“…Therefore, a possible explanation to the similar incidence of increased blood pressure in 2 groups might be that the chemotherapeutics and embolic agents, namely the microbeads, were of no difference between 2 groups. [ 22 , 23 ]…”