scholarly journals Creation of an ex-vivo bovine kidney flow model for testing embolic agents: work in progress

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Luis Garza ◽  
Ryan Bitar ◽  
Barrett O’Donnell ◽  
Matthew Parker ◽  
Carlos Ortiz ◽  
...  
Keyword(s):  
Flow Model ◽  
Ex Vivo ◽  
Embolic Agent ◽  
Segmental Artery ◽  
Bovine Kidney ◽  
Dose Area Product ◽  
Promising Tool ◽  
Embolic Agents ◽  
Area Product ◽  
Operational Time

Abstract Objectives To develop an ex- vivo perfusion flow model using a bovine kidney for future testing of embolic agents in an inexpensive and easy way. Methods Six bovine adult kidneys were used for this study. Kidneys were cannulated and perfused via a roller pump. Three embolic agents, coils, Gelfoam, and a glue mixture of Histoacryl + Lipiodol, were deployed by targeting three secondary segmental arteries per kidney via a 5Fr catheter under fluoroscopic guidance. Cannulation time, success rate of segmental artery selection and embolic agent deployment, total operational time, and fluoroscopy dose were recorded. Results Average kidney weight was 0.752 +/− 0.094 kg. All six bovine kidneys were successfully cannulated in 21.6 min +/− 3.0 min. Deployment of coils and glue was achieved in every case (12/12); however, Gelfoam injection was not successful in one instance (5/6, 83%). Coil deployment demonstrated no embolic effect while Gelfoam and glue injections demonstrated decreased distal contrast filling post-embolization. Mean dose area product was 12.9 ± 1.8 Gy·cm2, fluoroscopy time was 10 ± 4 min and operational time was 27 ± 8 min. Conclusions We describe the creation of an ex vivo bovine kidney flow model for the preclinical evaluation of different embolic materials. The flow model can be modified to provide extensive bench testing and it is a promising tool for hands -on training in basic and advanced embolization techniques .

scholarly journals Spot fluoroscopy: a novel innovative approach to reduce radiation dose in neurointerventional procedures

2016 ◽  
Vol 58 (5) ◽  
pp. 600-608 ◽  
Author(s):  
Ljubisa Borota ◽  
Lars Jangland ◽  
Per-Erik Åslund ◽  
Elisabeth Ronne-Engström ◽  
Christoffer Nyberg ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Region Of Interest ◽  
Field Of View ◽  
Endovascular Coiling ◽  
Dose Area Product ◽  
Air Kerma ◽  
Promising Tool ◽  
Fluoroscopic Time ◽  
Area Product ◽  
Neurointerventional Procedures

Background Increased interest in radiation dose reduction in neurointerventional procedures has led to the development of a method called “spot fluoroscopy” (SF), which enables the operator to collimate a rectangular or square region of interest anywhere within the general field of view. This has potential advantages over conventional collimation, which is limited to symmetric collimation centered over the field of view. Purpose To evaluate the effect of SF on the radiation dose. Material and Methods Thirty-five patients with intracranial aneurysms were treated with endovascular coiling. SF was used in 16 patients and conventional fluoroscopy in 19. The following parameters were analyzed: the total fluoroscopic time, the total air kerma, the total fluoroscopic dose-area product, and the fluoroscopic dose-area product rate. Statistical differences were determined using the Welch’s t-test. Results The use of SF led to a reduction of 50% of the total fluoroscopic dose-area product (CF = 106.21 Gycm2, SD = 99.06 Gycm2 versus SF = 51.80 Gycm2, SD = 21.03 Gycm2, p = 0.003884) and significant reduction of the total fluoroscopic dose-area product rate (CF = 1.42 Gycm2/min, SD = 0.57 Gycm2/s versus SF = 0.83 Gycm2/min, SD = 0.37 Gycm2/min, p = 0.00106). The use of SF did not lead to an increase in fluoroscopy time or an increase in total fluoroscopic cumulative air kerma, regardless of collimation. Conclusion The SF function is a new and promising tool for reduction of the radiation dose during neurointerventional procedures.

Assessment of human placenta as an ex-vivo vascular model for testing of liquid embolic agent injections with adjunctive techniques

2017 ◽  
Vol 10 (9) ◽  
pp. 892-895 ◽  
Author(s):  
Hideo Okada ◽  
Joonho Chung ◽  
Daniel M Heiferman ◽  
Demetrius K Lopes
Keyword(s):  
Human Placenta ◽  
Ex Vivo ◽  
Balloon Catheter ◽  
Embolic Agent ◽  
Vascular Model ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
The One ◽  
Plug Formation

PurposeThis project sought to test the utility of post-delivery human placenta (HP) as a vascular model for liquid embolic agent (LEA) simulation, along with adjunctive techniques.Materials and methodsTwelve LEA injections were performed under fluoroscopy in HP with two reflux control methods: dual lumen ‘mini’ balloon-catheter (n=9); and injection after proximal nBCA plug formation through a second microcatheter (‘pressure cooker’) (n=3). Measured outcomes included liquid embolic agent (LEA) advancement and reflux. Reflux was categorized into three grades: grade 0=no reflux; grade 1=occlusion of side branches without reflux beyond the balloon or plug; and grade 2=reflux beyond the balloon or plug.ResultsSimulation success was greater when a balloon was used rather than with a nBCA plug (89% vs 33%, P=0.054). In eight successful balloon-assisted injections, the reflux grades were: 50% grade 0; 12.5% grade 1; and 37.5% grade 2. The one successful nBCA plug injection had grade 2 reflux. All grade 2 balloon injections occurred when the balloon was positioned across a vessel bifurcation.ConclusionsHP provides excellent simulation for liquid embolic agents with a dual lumen balloon catheter.

Noninvasive patient tracker mask for spinal 3D navigation: does the required large-volume 3D scan involve a considerably increased radiation exposure?

2020 ◽  
Vol 33 (6) ◽  
pp. 838-844
Author(s):  
Jan-Helge Klingler ◽  
Ulrich Hubbe ◽  
Christoph Scholz ◽  
Florian Volz ◽  
Marc Hohenhaus ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Image Data ◽  
3D Image ◽  
Flat Panel ◽  
3D Navigation ◽  
Data Set ◽  
Dose Area Product ◽  
Flat Panel Detector ◽  
3D Scan ◽  
Area Product

OBJECTIVEIntraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study.METHODSPatients were retrospectively included if a thoracolumbar 3D scan was performed intraoperatively between 2016 and 2019 using a 3D C-arm with a large 30 × 30–cm flat-panel detector (3D scan volume 4096 cm3) or a 3D C-arm with a smaller 20 × 20–cm flat-panel detector (3D scan volume 2097 cm3), and the dose area product was available for the 3D scan. Additionally, the fluoroscopy time and the number of fluoroscopic images per 3D scan, as well as the BMI of the patients, were recorded.RESULTSThe authors compared 62 intraoperative thoracolumbar 3D scans using the 3D C-arm with a large flat-panel detector and 12 3D scans using the 3D C-arm with a small flat-panel detector. Overall, the 3D C-arm with a large flat-panel detector required more fluoroscopic images per scan (mean 389.0 ± 8.4 vs 117.0 ± 4.6, p < 0.0001), leading to a significantly higher dose area product (mean 1028.6 ± 767.9 vs 457.1 ± 118.9 cGy × cm2, p = 0.0044).CONCLUSIONSThe novel, noninvasive patient tracker mask facilitates intraoperative 3D navigation while eliminating the need for an additional skin incision with detachment of the autochthonous muscles. However, the use of this patient tracker mask requires a larger intraoperative 3D image data set for accurate registration, resulting in a 2.25 times higher radiation exposure to the patient. The use of the patient tracker mask should thus be based on an individual decision, especially taking into considering the radiation exposure and extent of instrumentation.

A Review of Electroporation-based Antitumor Skin Therapies and Investigation of Betulinic Acid-loaded Ointment

2018 ◽  
Vol 18 (5) ◽  
pp. 693-701
Author(s):  
Monika Bakonyi ◽  
Szilvia Berko ◽  
Gabor Eros ◽  
Gabor Varju ◽  
Cristina A. Dehelean ◽  
...  
Keyword(s):  
Betulinic Acid ◽  
High Efficiency ◽  
Antitumor Agents ◽  
Ex Vivo ◽  
Mouse Skin ◽  
Chemotherapeutic Agents ◽  
Hairless Mouse ◽  
Promising Tool ◽  
Acid Formulation ◽  
Invasive Method

Background: Electrochemotherapy is a novel treatment for cutaneous and subcutaneous tumors utilizing the combination of electroporation and chemotherapeutic agents. Since tumors have an increasing incidence nowadays as a result of environmental and genetic factors, electrochemotherapy could be a promising treatment for cancer patients. Objective: The aim of this article is to summarize the novel knowledge about the use of electroporation for antitumor treatments and to present a new application of electrochemotherapy with a well-known plant derived antitumor drug betulinic acid. For the review we have searched the databases of scientific and medical research to collect the available publications about the use of electrochemotherapy in the treatment of various types of cancer. Method: By the utilization of the available knowledge, we investigated the effect of electroporation on the penetration of a topically applied betulinic acid formulation into the skin by ex vivo Raman spectroscopy on hairless mouse skin. Results: Raman measurements have demonstrated that the penetration depth of betulinic acid can be remarkably ameliorated by the use of electroporation, so this protocol can be a possibility for the treatment of deeper localized cancer nodules. Furthermore, it proved the influence of various treatment times, since they caused different spatial distributions of the drug in the skin. Conclusion: The review demonstrates that electrochemotherapy is a promising tool to treat different kinds of tumors with high efficiency and with only a few moderate adverse effects. Moreover, it presents a non-invasive method to enhance the penetration of antitumor agents, which can offer novel prospects for antitumor therapies.

scholarly journals Emergency tips recanalisation and gastroesophageal varices embolisation with an ethylene vinyl alcohol copolymer agent (Squid) and detachable coils

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Massimo Venturini ◽  
Luigi Augello ◽  
Carolina Lanza ◽  
Marco Curti ◽  
Andrea Coppola ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Technical Note ◽  
Embolic Agent ◽  
Refractory Ascites ◽  
Gastroesophageal Varices ◽  
Ethylene Vinyl Alcohol ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Tube Removal ◽  
Detachable Coils

AbstractTransjugular intrahepatic portosystemic shunt (TIPS) is currently indicated as first therapeutic option in the main complications of portal hypertension, including bleeding gastroesophageal varices and refractory ascites. In case of bleeding gastroesophageal varices, an adjuvant embolisation within TIPS can be useful to prevent rebleeding. In the present technical note, the management in emergency of a patient with haemorrhagic shock due to bleeding gastroesophageal varices and occluded TIPS is reported. TIPS recanalisation with an adjunctive stent and high-pressure balloon angioplasty and gastroesophageal varices embolisation using detachable coils and a non-adhesive liquid embolic agent were performed during the same emergent procedure. After the procedure, clinical stabilisation of the patient was achieved, with blood transfusions suspension and Blakemore tube removal. At 6 months, regular TIPS patency at colour Doppler and no rebleeding episodes were recorded. To our knowledge, whilst coils are routinely used for varices embolisation, non-adhesive liquid embolic agents have been never mentioned. Liquid embolic agents seem to provide a stable plug strengthening the embolising action of the coils. Further studies involving a cohort of patients with long-term follow-up will be necessary to confirm whether this association can be more effective than coils alone in gastroesophageal varices embolisation.

Accuracy of a dose-area product compared to an absorbed dose to water at a point in a 2 cm diameter field

2016 ◽  
Vol 43 (7) ◽  
pp. 4085-4092 ◽  
Author(s):  
S. Dufreneix ◽  
A. Ostrowsky ◽  
B. Rapp ◽  
J. Daures ◽  
J. M. Bordy
Keyword(s):  
Absorbed Dose ◽  
Dose Area Product ◽  
Absorbed Dose To Water ◽  
Area Product

Establishment of dosimetric references in terms of dose-area product for small sizes MV X-ray beams

2015 ◽  
Vol 31 ◽  
pp. e52-e53 ◽  
Author(s):  
M. Le Roy ◽  
S. Dufreneix ◽  
J. Daures ◽  
F. Delaunay ◽  
J. Gouriou ◽  
...  
Keyword(s):  
X Ray ◽  
Dose Area Product ◽  
Area Product

Estimation of Radiation Exposure in the Pediatric Cath Lab in Ain Shams University; Cross-Sectional Observational Study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Abdelrazik ◽  
Youssef Amin ◽  
Alaa Roushdy ◽  
Maiy El Sayed
Keyword(s):  
Radiation Exposure ◽  
Radiation Dosage ◽  
University Hospital ◽  
Heart Catheterization ◽  
Radiation Doses ◽  
Device Closure ◽  
Cross Sectional ◽  
Dose Area Product ◽  
Area Product ◽  
Hospital Pediatric

Abstract Aim and objectives The aim of the study is to assess the average radiation doses recorded per procedure in Ain Shams University Hospital pediatric cath lab to set benchmarks of radiation exposure in our institute. Patients and Methods The study included 198 patients who presented to Ain Shams cardiac pediatric cath lab who undergone interventional (BPV, BAV, ASD device closure, VSD device closure, PDA coil/device closure, Coarctation Stent/balloon) and diagnostic (Hemodynamics study, Diagnostic cath) heart catheterization. Radiation doses were measured without any interference with the operator’s preferences. Results Radiation dosages were measured in total AirKerma, Dose area product (DAP), and fluoroscopy time to set the benchmarks for radiation exposure in our institute per procedure. VSD device closure showed the highest radiation exposure followed by Coarctation stenting. Lowest radiation dosage was in PDA coil closure followed by ASD device closure then BPV. Conclusion Benchmarks for radiation exposure per procedure in pediatric cath lab in our institute were set and compared to each other.

scholarly journals Clinical apparatus for the reduction of dose area product for patients undergoing x-ray catheterization

2015 ◽  
Vol 42 (1) ◽  
pp. 521-530 ◽  
Author(s):  
Normand Robert ◽  
Kristina N. Watt ◽  
Sophie Rochette ◽  
Lionel Desponds ◽  
Régis Vaillant ◽  
...  
Keyword(s):  
X Ray ◽  
Dose Area Product ◽  
Area Product
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