杨宁介入医学网

Particle

• Catheter hub: risk of  clogging  [klɑg] 阻塞 due lack of  flexibility
• Porosity [pɔ:ˈrɒsəti] 有空性  of the particles  allow their deformation  through their passage into  the microcatheter
• Ideally particles recover  their original spherical [ˈsferɪkl]  shape after passing  through the catheter tip

Microcatheter

• Additional considerations:

• The use of Cone Beam CT and navigation tools for embolization  purposes has become more often integrated [ˈɪntɪgreɪtɪd in TACE

• Optimal CBCT protocols may require high injection rate of contrast  media.

• The choice of adequate microcatheters ahead of time is mandatory.

Specific situations:

TACE with Drug Eluting Beads:

Shrinkage [ˈʃrɪŋkɪdʒ] 皱缩 of the beads after being loaded with chemo  agent:

 

• 300–500 mic DC beads
• 300-500 mic becomes 380 mic ( 12% shrinkage when  40 mg of doxorubicin is loaded in 1 vial)

Lewis AL, Gonzalez MV, Lloyd AW et al (2006) DC bead:in vitro characterization of a drug-delivery device for transarterial chemoembolization. J Vasc Interv Radiol 17:335–342

 

300–500 mic beads could pass through the 1.8Fr ID ( inner diameter ):0.017 inch (431.8 mic)

(Very High Dilution) 

 

• Decrease in the microspheres’ diameter (chemo)
• Elastic deformation of the microspheres while passing through the catheter,
• Inner diameter expansion of the microcatheter.

need for smaller caliber microcatheters?

• Superselective catheterization (TACE)
• Small Caliber of the vessels (PAE)

Superselective catheterization (TACE)

Small Caliber of the vessels (PAE)

• Specific catheters for  flow directed  embolization and  antireflux

            Surefire
 

• Occlusion balloon:

            Scepter (Microvention  Terumo)

Surefire	Scepter (Microvention  Terumo)