常见血管内栓塞材料的临床应用进展
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摘要
血管内栓塞术是一种经导管向靶血管内注入栓塞材料,使靶血管闭塞的技术。常见的血管内栓塞材料可分为固体栓塞材料与液体栓塞材料两大类。不同栓塞材料的物理、化学性质大多不同。熟悉这些栓塞材料的优点和缺点,并掌握其使用方法与作用机制,有助于在临床应用中根据不同的需求选择合适的栓塞材料。本文综述了常见血管内栓塞材料的特点与应用。
Transarterial embolization(TAE) is a technique by which embolic materials are injected into the target vessel through a catheter to occlude the target vessel. Currently, embolic materials commonly used in TAE can be divided into two categories: solid embolic materials and liquid embolic materials. The physical and chemical properties of different embolic materials are different. To be familiar with the advantages and disadvantages of these embolic materials, as well as the methods and mechanisms, is helpful for clinicians to select appropriate embolic materials according to different needs in clinical application. This article reviews the characteristics and application of the embolic materials commonly used in TAE.
Transarterial embolization(TAE) is a technique by which embolic materials are injected into the target vessel through a catheter to occlude the target vessel. Currently, embolic materials commonly used in TAE can be divided into two categories: solid embolic materials and liquid embolic materials. The physical and chemical properties of different embolic materials are different. To be familiar with the advantages and disadvantages of these embolic materials, as well as the methods and mechanisms, is helpful for clinicians to select appropriate embolic materials according to different needs in clinical application. This article reviews the characteristics and application of the embolic materials commonly used in TAE.
引文
[1] Verret V,Ghegediban SH,Wassef M,et al. The arterial distribution of Embozene and Embosphere microspheres in sheep kidney and uterus embolization models[J]. J Vasc Interv Radiol,2011,22(2):220-228.
[2] Derdeyn CP,Moran CJ,Cross DT,et al. Polyvinyl alcohol particle size and suspension characteristics[J]. Am J Neuroradiol,1995,16(6):1335-1343.
[3] Germano IM,Davis RL,Wilson CB,et al. Histopathological followup study of 66 cerebral arteriovenous malformations after therapeutic embolization with polyvinyl alcohol[J]. J Neurosurg,1992,76(4):607-614.
[4] Stampfl S,Bellemann N,Stampfl U,et al. Arterial distribution characteristics of Embozene particles and comparison with other spherical embolic agents in the porcine acute embolization model[J].J Vasc Interv Radiol,2009,20(12):1597-1607.
[5] Laurent A. Microspheres and nonspherical particles for embolization[J]. Tech Vasc Interv Radiol,2007,10(4):248-256.
[6] Hao MZ, Lin HL, Chen QZ, et al. Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma[J]. J Dig Dis,2017,18(1):31-39.
[7]沈云峰,廖予妹.子宫动脉栓塞术在妇产科中的应用[J/CD].中华介入放射学电子杂志,2015,3(1):56-59.
[8] Duvnjak S,Ravn P,Green A,et al. Uterine fibroid embolization with acrylamido polyvinyl microspheres:prospective 12-month clinical and MRI follow-up study[J]. Acta Radiol,2017,58(8):952-958.
[9] Chua GC,Wilsher M,Young MP,et al. Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization[J]. Clin Radiol,2005,60(1):116-122.
[10] Siskin GP,Beck A,Schuster M,et al. Leiomyoma infarction after uterine artery embolization:a prospective randomized study comparing tris-acryl gelatin microspheres versus polyvinyl alcohol microspheres[J]. J Vasc Interv Radiol,2008,19(1):58-65.
[11] Yu SC,Cho CC,Hung EH,et al. Prostate artery embolization for complete urinary outflow obstruction due to benign prostatic hypertrophy[J]. Cardiovasc Intervent Radiol,2017,40(1):33-40.
[12]施昌盛,杨庆,李成,等. Embosphere微球联合弹簧圈栓塞治疗大咯血的疗效分析[J/CD].中华介入放射学电子杂志,2017,5(4):269-272.
[13]朱国庆,虞希祥,肖池金,等. Embosphere微球联合碘油肝动脉栓塞治疗原发性肝癌破裂大出血25例疗效分析[J].介入放射学杂志,2014,23(2):156-158.
[14]李京雨,张新国.甲状腺动脉栓塞治疗甲状腺机能亢进[J].中华放射学杂志,2001,35(3):202-204.
[15] Facciorusso A. Drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma:Current state of the art[J].World J Gastroenterol,2018,24(2):161-169.
[16] Kim HC. Radioembolization for the treatment of hepatocellular carcinoma[J]. Clin Mol Hepatol,2017,23(2):109-114.
[17]金三宝,陈忠,司捷旻,等.肾动脉栓塞致下肢栓塞一例报告[J].中华泌尿外科杂志,2003,24(7):486.
[18] Cheong JY,Kong TW,Son JH,et al. Outcome of pelvic arterial embolization for postpartum hemorrhage:A retrospective review of117 cases[J]. Obstet Gynecol Sci,2014,57(1):17-27.
[19]金泳海,刘一之,倪才方,等.骨盆骨折合并盆腔大出血的急诊栓塞治疗[J].临床放射学杂志,2006,25(9):862-865.
[20]官彬,廖先国,文鹏程,等.肾癌外科根治性切除术前经动脉插管栓塞的临床价值[J].重庆医学,2015(22):3072-3075.
[21]张勇,周玉梅,陈淑君,等.明胶海绵颗粒联合凝血酶预防CT引导下卵巢癌穿刺活检术后针道出血[J].介入放射学杂志,2016,25(5):412-415.
[22] Goldstein HM,Wallace S,Anderson JH,et al. Transcatheter occlusion of abdominal tumors[J]. Radiology,1976,120(3):539-545.
[23]吕朋华,王立富,王书祥,等.经导管组织黏合剂结合弹簧圈栓塞脾动脉瘤[J].介入放射学杂志,2011,20(9):737-740.
[24]高见书,张国兵,周国伟,等.电解脱弹簧圈封堵先天性冠状动脉-肺动脉瘘30例临床疗效分析[J].介入放射学杂志,2018,27(5):400-403.
[25] Dudeck O, Bulla K, Wieners G, et al. Embolization of the gastroduodenal artery before selective internal radiotherapy:a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils[J]. Cardiovasc Intervent Radiol,2011,34(1):74-80.
[26] Bechara CF, Weakley SM, Kougias P, et al. Percutaneous treatment of varicocele with microcoil embolization:comparison of treatment outcome with laparoscopic varicocelectomy[J]. Vascular,2009,17(Suppl 3):S129-S136.
[27] Dutton JA,Jackson JE,Hughes JM,et al. Pulmonary arteriovenous malformations:results of treatment with coil embolization in 53patients[J]. AJR Am J Roentgenol,1995,165(5):1119-1125.
[28] Prasad V,Chan RP,Faughnan ME. Embolotherapy of pulmonary arteriovenous malformations:efficacy of platinum versus stainless steel coils[J]. J Vasc Interv Radiol,2004,15(2 Pt 1):153-160.
[29] Falagas ME,Nikou SA,Siempos II. Infections related to coils used for embolization of arteries:review of the published evidence[J]. J Vasc Interv Radiol,2007,18(6):697-701.
[30] Nakakuma K,Tashiro S,Hiraoka T,et al. Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer[J]. Cancer,1983,52(12):2193-2200.
[31] Ramsey DE,Kernagis LY,Soulen MC,et al. Chemoembolization of hepatocellular carcinoma[J]. J Vasc Interv Radiol,2002,13(9 Pt2):S211-S221.
[32] Lencioni R. Chemoembolization for Hepatocellular Carcinoma[J].Semin Oncol,2012,39(4):503-509.
[33]中国抗癌协会肝癌专业委员会.原发性肝癌规范化诊治专家共识[J].临床肿瘤学杂志,2009,14(3):259-269.
[34]中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].传染病信息,2017,16(3):705-720.
[35] Mabed M,Esmaeel M,El-Khodary T,et al. A randomized controlled trial of transcatheter arterial chemoembolization with lipiodol,doxorubicin and cisplatin versus intravenous doxorubicin for patients with unresectable hepatocellular carcinoma[J]. Eur J Cancer Care(Engl),2009,18(5):492-499.
[36] Lo CM,Ngan H,Tso WK,et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma[J]. Hepatology,2002,35(5):1164-1171.
[37] Lencioni R,de Baere T,Soulen MC,et al. Lipiodol transarterial chemoembolization for hepatocellular carcinoma:A systematic review of efficacy and safety data[J]. Hepatology,2016,64(1):106-116.
[38] Pollak JS, White RI. The use of cyanoacrylate adhesives in peripheral embolization[J]. J Vasc Interv Radiol,2001,12(8):907-913.
[39] Koch MJ, Stapleton CJ, Agarwalla PK, et al. Open and endovascular treatment of spinal dural arteriovenous fistulae:a 10-year experience[J]. J Neurosurg Spine,2017,26(4):519-523.
[40] Wajswol E,Jazmati T,Contractor S,et al. Portal vein embolization utilizing N-butyl cyanoacrylate for contralateral lobe hypertrophy prior to liver resection:A systematic review and Meta-analysis[J].Cardiovasc Intervent Radiol,2018,41(9):1302-1312.
[41] Kwon JH,Han YH. Efficacy and safety of superselective transcatheter arterial embolization of upper and lower gastrointestinal bleeding using N-butyl-2-cyanoacrylate[J]. Emerg Radiol,2018,25(2):111-120.
[42] Jahan R, Murayama Y, Gobin YP, et al. Embolization of arteriovenous malformations with Onyx:clinicopathological experience in 23 patients[J]. Neurosurgery,2001,51(6):1525-1526.
[43] Graif A,Vance AZ,Garcia MJ,et al. Transcatheter embolization of type I endoleaks associated with endovascular abdominal aortic aneurysm repair using ethylene vinyl alcohol copolymer[J]. Vasc Endovascular Surg,2017,51(1):28-32.
[44] Müller-Wille R,Heiss P,Herold T,et al. Endovascular treatment of acute arterial hemorrhage in trauma patients using ethylene vinyl alcohol copolymer(Onyx)[J]. Cardiovasc Intervent Radiol,2012,35(1):65-75.
[45] Lenhart M,Paetzel C,Sackmann M,et al. Superselective arterial embolisation with a liquid polyvinyl alcohol copolymer in patients with acute gastrointestinal haemorrhage[J]. Eur Radiol,2010,20(8):1994-1999.
[2] Derdeyn CP,Moran CJ,Cross DT,et al. Polyvinyl alcohol particle size and suspension characteristics[J]. Am J Neuroradiol,1995,16(6):1335-1343.
[3] Germano IM,Davis RL,Wilson CB,et al. Histopathological followup study of 66 cerebral arteriovenous malformations after therapeutic embolization with polyvinyl alcohol[J]. J Neurosurg,1992,76(4):607-614.
[4] Stampfl S,Bellemann N,Stampfl U,et al. Arterial distribution characteristics of Embozene particles and comparison with other spherical embolic agents in the porcine acute embolization model[J].J Vasc Interv Radiol,2009,20(12):1597-1607.
[5] Laurent A. Microspheres and nonspherical particles for embolization[J]. Tech Vasc Interv Radiol,2007,10(4):248-256.
[6] Hao MZ, Lin HL, Chen QZ, et al. Safety and efficacy of transcatheter arterial chemoembolization with embospheres in treatment of hepatocellular carcinoma[J]. J Dig Dis,2017,18(1):31-39.
[7]沈云峰,廖予妹.子宫动脉栓塞术在妇产科中的应用[J/CD].中华介入放射学电子杂志,2015,3(1):56-59.
[8] Duvnjak S,Ravn P,Green A,et al. Uterine fibroid embolization with acrylamido polyvinyl microspheres:prospective 12-month clinical and MRI follow-up study[J]. Acta Radiol,2017,58(8):952-958.
[9] Chua GC,Wilsher M,Young MP,et al. Comparison of particle penetration with non-spherical polyvinyl alcohol versus trisacryl gelatin microspheres in women undergoing premyomectomy uterine artery embolization[J]. Clin Radiol,2005,60(1):116-122.
[10] Siskin GP,Beck A,Schuster M,et al. Leiomyoma infarction after uterine artery embolization:a prospective randomized study comparing tris-acryl gelatin microspheres versus polyvinyl alcohol microspheres[J]. J Vasc Interv Radiol,2008,19(1):58-65.
[11] Yu SC,Cho CC,Hung EH,et al. Prostate artery embolization for complete urinary outflow obstruction due to benign prostatic hypertrophy[J]. Cardiovasc Intervent Radiol,2017,40(1):33-40.
[12]施昌盛,杨庆,李成,等. Embosphere微球联合弹簧圈栓塞治疗大咯血的疗效分析[J/CD].中华介入放射学电子杂志,2017,5(4):269-272.
[13]朱国庆,虞希祥,肖池金,等. Embosphere微球联合碘油肝动脉栓塞治疗原发性肝癌破裂大出血25例疗效分析[J].介入放射学杂志,2014,23(2):156-158.
[14]李京雨,张新国.甲状腺动脉栓塞治疗甲状腺机能亢进[J].中华放射学杂志,2001,35(3):202-204.
[15] Facciorusso A. Drug-eluting beads transarterial chemoembolization for hepatocellular carcinoma:Current state of the art[J].World J Gastroenterol,2018,24(2):161-169.
[16] Kim HC. Radioembolization for the treatment of hepatocellular carcinoma[J]. Clin Mol Hepatol,2017,23(2):109-114.
[17]金三宝,陈忠,司捷旻,等.肾动脉栓塞致下肢栓塞一例报告[J].中华泌尿外科杂志,2003,24(7):486.
[18] Cheong JY,Kong TW,Son JH,et al. Outcome of pelvic arterial embolization for postpartum hemorrhage:A retrospective review of117 cases[J]. Obstet Gynecol Sci,2014,57(1):17-27.
[19]金泳海,刘一之,倪才方,等.骨盆骨折合并盆腔大出血的急诊栓塞治疗[J].临床放射学杂志,2006,25(9):862-865.
[20]官彬,廖先国,文鹏程,等.肾癌外科根治性切除术前经动脉插管栓塞的临床价值[J].重庆医学,2015(22):3072-3075.
[21]张勇,周玉梅,陈淑君,等.明胶海绵颗粒联合凝血酶预防CT引导下卵巢癌穿刺活检术后针道出血[J].介入放射学杂志,2016,25(5):412-415.
[22] Goldstein HM,Wallace S,Anderson JH,et al. Transcatheter occlusion of abdominal tumors[J]. Radiology,1976,120(3):539-545.
[23]吕朋华,王立富,王书祥,等.经导管组织黏合剂结合弹簧圈栓塞脾动脉瘤[J].介入放射学杂志,2011,20(9):737-740.
[24]高见书,张国兵,周国伟,等.电解脱弹簧圈封堵先天性冠状动脉-肺动脉瘘30例临床疗效分析[J].介入放射学杂志,2018,27(5):400-403.
[25] Dudeck O, Bulla K, Wieners G, et al. Embolization of the gastroduodenal artery before selective internal radiotherapy:a prospectively randomized trial comparing standard pushable coils with fibered interlock detachable coils[J]. Cardiovasc Intervent Radiol,2011,34(1):74-80.
[26] Bechara CF, Weakley SM, Kougias P, et al. Percutaneous treatment of varicocele with microcoil embolization:comparison of treatment outcome with laparoscopic varicocelectomy[J]. Vascular,2009,17(Suppl 3):S129-S136.
[27] Dutton JA,Jackson JE,Hughes JM,et al. Pulmonary arteriovenous malformations:results of treatment with coil embolization in 53patients[J]. AJR Am J Roentgenol,1995,165(5):1119-1125.
[28] Prasad V,Chan RP,Faughnan ME. Embolotherapy of pulmonary arteriovenous malformations:efficacy of platinum versus stainless steel coils[J]. J Vasc Interv Radiol,2004,15(2 Pt 1):153-160.
[29] Falagas ME,Nikou SA,Siempos II. Infections related to coils used for embolization of arteries:review of the published evidence[J]. J Vasc Interv Radiol,2007,18(6):697-701.
[30] Nakakuma K,Tashiro S,Hiraoka T,et al. Studies on anticancer treatment with an oily anticancer drug injected into the ligated feeding hepatic artery for liver cancer[J]. Cancer,1983,52(12):2193-2200.
[31] Ramsey DE,Kernagis LY,Soulen MC,et al. Chemoembolization of hepatocellular carcinoma[J]. J Vasc Interv Radiol,2002,13(9 Pt2):S211-S221.
[32] Lencioni R. Chemoembolization for Hepatocellular Carcinoma[J].Semin Oncol,2012,39(4):503-509.
[33]中国抗癌协会肝癌专业委员会.原发性肝癌规范化诊治专家共识[J].临床肿瘤学杂志,2009,14(3):259-269.
[34]中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].传染病信息,2017,16(3):705-720.
[35] Mabed M,Esmaeel M,El-Khodary T,et al. A randomized controlled trial of transcatheter arterial chemoembolization with lipiodol,doxorubicin and cisplatin versus intravenous doxorubicin for patients with unresectable hepatocellular carcinoma[J]. Eur J Cancer Care(Engl),2009,18(5):492-499.
[36] Lo CM,Ngan H,Tso WK,et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma[J]. Hepatology,2002,35(5):1164-1171.
[37] Lencioni R,de Baere T,Soulen MC,et al. Lipiodol transarterial chemoembolization for hepatocellular carcinoma:A systematic review of efficacy and safety data[J]. Hepatology,2016,64(1):106-116.
[38] Pollak JS, White RI. The use of cyanoacrylate adhesives in peripheral embolization[J]. J Vasc Interv Radiol,2001,12(8):907-913.
[39] Koch MJ, Stapleton CJ, Agarwalla PK, et al. Open and endovascular treatment of spinal dural arteriovenous fistulae:a 10-year experience[J]. J Neurosurg Spine,2017,26(4):519-523.
[40] Wajswol E,Jazmati T,Contractor S,et al. Portal vein embolization utilizing N-butyl cyanoacrylate for contralateral lobe hypertrophy prior to liver resection:A systematic review and Meta-analysis[J].Cardiovasc Intervent Radiol,2018,41(9):1302-1312.
[41] Kwon JH,Han YH. Efficacy and safety of superselective transcatheter arterial embolization of upper and lower gastrointestinal bleeding using N-butyl-2-cyanoacrylate[J]. Emerg Radiol,2018,25(2):111-120.
[42] Jahan R, Murayama Y, Gobin YP, et al. Embolization of arteriovenous malformations with Onyx:clinicopathological experience in 23 patients[J]. Neurosurgery,2001,51(6):1525-1526.
[43] Graif A,Vance AZ,Garcia MJ,et al. Transcatheter embolization of type I endoleaks associated with endovascular abdominal aortic aneurysm repair using ethylene vinyl alcohol copolymer[J]. Vasc Endovascular Surg,2017,51(1):28-32.
[44] Müller-Wille R,Heiss P,Herold T,et al. Endovascular treatment of acute arterial hemorrhage in trauma patients using ethylene vinyl alcohol copolymer(Onyx)[J]. Cardiovasc Intervent Radiol,2012,35(1):65-75.
[45] Lenhart M,Paetzel C,Sackmann M,et al. Superselective arterial embolisation with a liquid polyvinyl alcohol copolymer in patients with acute gastrointestinal haemorrhage[J]. Eur Radiol,2010,20(8):1994-1999.