Bibliographic Details
| Title: |
Reversible occlusion of the pulmonary vasculature by transarterial embolisation with degradable starch microspheres: preclinical assessment in a human isolated lung perfusion model |
| Authors: |
Benedikt M. Schaarschmidt, Alexis Slama, Stéphane Collaud, Özlem Okumus, Hannah Steinberg, Sebastian Bauer, Hans-Ulrich Schildhaus, Jens Theysohn, Clemens Aigner |
| Source: |
European Radiology Experimental, Vol 6, Iss 1, Pp 1-11 (2022) |
| Publisher Information: |
SpringerOpen, 2022. |
| Publication Year: |
2022 |
| Collection: |
LCC:Medical physics. Medical radiology. Nuclear medicine |
| Subject Terms: |
alpha-Amylases, Degradable starch microspheres, Lung neoplasms, Perfusion imaging, Tomography (x-ray computed), Medical physics. Medical radiology. Nuclear medicine, R895-920 |
| More Details: |
Abstract Background Transpulmonary embolisation (TPE) using degradable starch microspheres (DSM) is a potential approach to treat pulmonary metastases. However, there is a paucity of detailed information on perfusion dynamics. The aim of this study was to establish a human ex vivo isolated lung perfusion (ILP) model to observe and evaluate the effects of DSM-TPE in a near-physiologic setting. Methods ILP was carried out on six surgically resected lung lobes. At baseline, computed tomography (CT), including CT perfusion imaging (CTPI), and histopathological sampling were performed (t30). DSM-TPE was initiated and increased stepwise (t45, t60, t75, and t90) to be followed by CT imaging, histopathological sampling, and pulmonary arterial pressure (PAP). After the last assessment (t90), alpha-amylase was injected into the pulmonary artery to allow for DSM hydrolysation and two additional assessments (t105; t120). Histopathological specimens were evaluated using a semiquantitative ordinal score. CTPI was used for time to peak (TTP) analysis. Results After DSM administration, PAP and TTP increased significantly: PAP slope 95% confidence interval (CI) 0.104−0.483, p = 0.004; TTP t30 versus t45, p = 0.046. After the addition of alpha-amylase, functional parameters reverted to values comparable to baseline. In histopathological samples, embolisation grades increased significantly until t90 (slope 95% CI 0.027−0.066, p < 0.001) and decreased after addition of alpha-amylase (slope 95% CI -0.060−0.012, p = 0.165), Conclusions The ILP model demonstrated successfully both the physiologic effect of DSM-TPE on human lungs and its reversibility with alpha-amylase. Thus, it can be used as a near-physiologic preclinical tool to simulate and assess later clinical approaches. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2509-9280 |
| Relation: |
https://doaj.org/toc/2509-9280 |
| DOI: |
10.1186/s41747-021-00255-9 |
| Access URL: |
https://doaj.org/article/b443f183da9d43eabe3b2bf04fd99037 |
| Accession Number: |
edsdoj.b443f183da9d43eabe3b2bf04fd99037 |
| Database: |
Directory of Open Access Journals |
