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Panneau J, Mege D, Di Bisceglie M, Duclos J, Habert P, Bartoli A, Vidal V, Tradi F. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. Radiographics 2022; 42:E226. [DOI: 10.1148/rg.229013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Panneau J, Mege D, Di Biseglie M, Duclos J, Habert P, Bartoli A, Vidal V, Tradi F. Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques. Radiographics 2022; 42:1829-1844. [DOI: 10.1148/rg.220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Panneau J, Mege D, Biseglie MD, Duclos J, Habert P, Vidal V, Tradi F. Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease. Semin Intervent Radiol 2022; 39:194-202. [PMID: 35781988 DOI: 10.1055/s-0042-1745800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Julien Panneau
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Diane Mege
- Department of Visceral Surgery, Aix-Marseille University, Hôpital de la Timone, Marseille, France
| | - Mathieu Di Biseglie
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Julie Duclos
- Department of Visceral Surgery, Aix-Marseille University, Hôpital de la Timone, Marseille, France
| | - Paul Habert
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Vincent Vidal
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
| | - Farouk Tradi
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France.,Aix Marseille University, LIIE, Marseille, France.,Aix Marseille University, CERIMED, Marseille, France
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Tradi F, Panneau J, Brige P, Mege D, Habert P, Hak JF, Di Bisceglie M, Vidal V. Evaluation of Multiple Embolic Agents for Embolization of the Superior Rectal Artery in an Animal Model. Cardiovasc Intervent Radiol 2022; 45:510-519. [PMID: 34988702 DOI: 10.1007/s00270-021-03041-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/04/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To prospectively compare the safety of transcatheter embolization of superior rectal arteries in healthy pigs with multiple agents such as coils, spheres and liquids. MATERIALS AND METHODS Nine adult domestic pigs (three males, mean weight: 60 kg [50-70]) were randomly assigned to the embolization group: copolymer of ethylene vinyl alcohol (EVOH)-Onyx® (group 1, n = 3), microspheres 500 µ (group 2, n = 3), 2-mm micro-coils (group 3, n = 3). After a selective angiogram has been acquired, the embolic agent was infused at the distal part of rectal arteries. An angio-CT was performed before and after each embolization. After one week, angiography was repeated prior to euthanasia. At necropsy, the anorectal juncture was removed for histopathologic examination. RESULTS At necropsy, 100% of animals embolized with Onyx developed a significant necrosis zone of the distal part of the rectum. Histological examination revealed a mural infarction. For the micro-coil and microsphere groups, gross examination of the intestines did not reveal any evidence of ischaemia. The coils were found in the distal arterial vasculature of the meso-rectum, allowing a downstream revascularization by collaterals. The microspheres and onyx in the rectal wall, more distally. CONCLUSION Microspheres appear to induce fewer histologic complications than the liquid embolic agent and provide a more distal occlusion than micro-coils. These results suggest that, for superior rectal artery embolization, a super-selective embolization using spheres in human clinical conditions should be more effective and as safe as coil embolization. EVOH might be an unsafe embolization agent for haemorrhoids.
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Affiliation(s)
- Farouk Tradi
- Department of Interventional Radiology, Marseille Public University Hospital System (APHM), La Timone University Hospital, 264 Rue Saint Pierre, 13385, Marseille, Cedex 05, France.
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France.
| | - Julien Panneau
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
| | - Pauline Brige
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
| | - Diane Mege
- Department of General and Visceral Surgery, APHM, La Timone University Hospital, 264 Rue Saint Pierre, 13385, Marseille, Cedex 05, France
- Vascular Research Center of Marseille (VRCM), INSERM UMR-S 1076, Aix Marseille University, 27 Boulevard Jean Moulin 13005, Marseille, France
| | - Paul Habert
- Department of Interventional Radiology, Marseille Public University Hospital System (APHM), La Timone University Hospital, 264 Rue Saint Pierre, 13385, Marseille, Cedex 05, France
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
| | - Jean Francois Hak
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
| | - Mathieu Di Bisceglie
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
| | - Vincent Vidal
- Department of Interventional Radiology, Marseille Public University Hospital System (APHM), La Timone University Hospital, 264 Rue Saint Pierre, 13385, Marseille, Cedex 05, France
- Experimental Interventional Imaging Laboratory (LIIE), UR 4264, Aix Marseille University, 27 boulevard Jean Moulin, 13005, Marseille, France
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Di Bisceglie M, Hak JF, Diop AD, Salazar G, Brige P, Panneau J, Tradi F, Habert P, Campion JY, Diop AN, Soulez G, Guillet B, Vidal V. FairEmbo Concept for Arterial Embolizations: In Vivo Feasibility and Safety Study with Suture-Based Microparticles Compared with Microspheres. Cardiovasc Intervent Radiol 2020; 44:625-632. [PMID: 33099701 DOI: 10.1007/s00270-020-02678-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/03/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Microspheres are effective embolic agents, especially for the management of bleeding and oncologic lesions. The first FairEmbo study reported the effectiveness of embolization using suture fragments. The effectiveness and safety of arterial embolization with suture-based microparticles (SBM) were assessed in a swine model. MATERIALS AND METHODS In this ethical-approved animal study, a polar artery in each kidney was embolized in four swine: one side with hand-cut non-absorbable SBM (Flexocrin 2®) and the contralateral side with Embozene® 900 for comparison. Swine were followed for 3 months (M3) to evaluate the effectiveness and the safety of SBM. Follow-up protocol included clinical monitoring, computed tomography (CT) control and digital subtraction angiography (DSA), followed by histological analyses. The SBM confection parameters were evaluated by automatic microscopic sizer. RStudio software and Mann-Whitney test (significance at P < 0.05) were used for statistics. RESULTS The average size of SBM was 1002 μm (SD = 258). All targets were effectively embolized by SBM with an angiogram defect estimated at 45.6% (95% CI [35.9-55.2]), compared to 40.5% (95% CI [30.6-55.5]) for Embozene® group (P = 0.342). The average duration of SBM embolization procedure was significantly increased compared to Embozene® embolization (1202 s versus 222 s, P = 0.029). There were no statistical differences in M3 DSA and CT for SBM and Embozene®, with persistence of partial arterial occlusion and atrophic embolized area. No postoperative complications were observed on clinical and CT controls. CONCLUSION This experimental study suggests that embolization with SBM is feasible, safe and effective in short- and medium-term follow-up as compared to microspheres.
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Affiliation(s)
- Mathieu Di Bisceglie
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France.
- LiiE, Aix Marseille University, Marseille, France.
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France.
| | - Jean-Francois Hak
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Abdoulaye Dione Diop
- Diagnostic and Medical Imaging Center, Fann National University Hospital Center, 5035, Dakar, Senegal
| | - Gloria Salazar
- Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Pauline Brige
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Julien Panneau
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Farouk Tradi
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
- Department of Radiology, University Hospital Center of Montreal, Montreal, Canada
| | - Paul Habert
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | | | | | - Gilles Soulez
- Department of Radiology, University Hospital Center of Montreal, Montreal, Canada
| | - Benjamin Guillet
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
- INSERM1263, INRA 1260, C2VN, Aix Marseille University, Marseille, France
- Department of Radiopharmacy, APHM, Marseille, France
| | - Vincent Vidal
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
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