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

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Hak, Jean-François | Tradi, Farouk | Bobot, Mickael | Brige, Pauline | Habert, Paul | Chopinet, Sophie | Haffner, Aurélie | Soulez, Gilles | Guillet, Benjamin | Vidal, Vincent

Edité par CCSD -

International audience. 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)). e 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.

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