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Research ArticleNeurointervention

Organic Solvents as Vehicles for Precipitating Liquid Embolics: A Comparative Angiotoxicity Study with Superselective Injections of Swine Rete Mirabile

O. Dudeck, O. Jordan, K.T. Hoffmann, A.F. Okuducu, K. Tesmer, T. Kreuzer-Nagy, D.A. Rüfenacht, E. Doelker and R. Felix
American Journal of Neuroradiology October 2006, 27 (9) 1900-1906;

Article Figures & Data

Figures

  • Fig 1.
    Fig 1.

    Superselective catheterization of the artery of the rete.

    The microcatheter is positioned in the ascending pharyngeal artery (arrow) distally to the muscular branch for infusion of 0.8 mL of solvent over 60 seconds.

  • Fig 2.
    Fig 2.

    Vasospasm of the artery of the rete after infusion of DMSO.

    A, Postinfusion DSA 3 minutes after infusion of DMSO reveals severe grade 3 vasospasm of the ascending pharyngeal artery (arrows).

    B, Repeat DSA shows complete resolution of vasospasm at 23 minutes after DMSO infusion.

  • Fig 3.
    Fig 3.

    Vasospasm of the artery of the rete after infusion of DMI.

    A, Postinfusion DSA 3 minutes after the injection of DMI demonstrates mild grade 1 vasospasm of the ascending pharyngeal artery (arrow).

    B, Repeat DSA 8 minutes after DMI infusion confirms complete resolution of vasospasm.

  • Fig 4.
    Fig 4.

    Temporal courses of solvent induced changes in diameters of swine artery of the rete (n = 28) expressed as a percentage of baseline values before solvent injections. Among all solvents investigated, DMSO provoked the most severe initial vasospasm that resolved the most slowly, whereas DMI and NMP induced only weak vasospasms that resolved quickly.

  • Fig 5.
    Fig 5.

    Histopathologic changes of retia after solvent infusion.

    A, Separation of few endothelial cells in 1 retial artery (arrow) (hematoxylin-eosin; original magnification, 200×). Rete was exposed to 0.8 mL of DMSO per 60 seconds.

    B, Right-sided rete of swine 8 exposed to 0.8 mL of glycofurol 75 per 60 seconds shows arterial wall hyperplasia, including all vessel layers (hematoxylin-eosin; original magnification, 200×).

    C, Left-sided rete of swine 12 exposed to 0.8 mL of solketal shows endothelial denuding of several microarteries (arrows) (hematoxylin-eosin; original magnification, 200×).

    D, Note intact internal elastic lamina within these vessels (arrows) (Van Gieson’s elastic; original magnification, 200×).

Tables

  • Table 1:

    Experimental data

    Swine No.SideSolvent Infused (0.8 mL/60 s)% of Vessel Narrowing/Vasospasm Score After:
    3 min8 min13 min18 min23 min28 min
    1RightDMSO50/2.551/2.541/236/223/215/1
    LeftGlycofurol 7565/345/20/00/0
    2RightDMI0/00/00/0
    LeftNMP28/218/10/0
    3RightSolketal50/2.520/10/00/0
    LeftEthyl lactate50/2.519/10/00/0
    4RightDMSO82/435/20/00/0
    LeftDMI32/221/10/0
    5RightNMP0/00/00/0
    LeftSolketal41/20/00/0
    6RightGlycofurol 7545/223/118/10/0
    LeftEthyl lactate82/423/10/00/0
    7RightDMSO36/221/117/10/00/0
    LeftNMP14/10/00/0
    8RightGlycofurol 7521/10/00/0
    LeftDMI23/115/10/0
    9RightEthyl lactate40/220/10/00/0
    LeftNMP0/00/00/0
    10RightDMSO68/340/218/111/10/00/0
    LeftSolketal53/350/2.513/10/0
    11RightDMI39/00/00/0
    LeftEthyl lactate42/226/1.514/10/0
    12RightGlycofurol 7536/216/10/00/0
    LeftSolketal59/325/1.50/00/0
    13RightNMP17/10/00/0
    LeftDMI0/00/00/0
    14RightNMP10/10/00/0
    LeftGlycofurol 7538/218/10/00/0

    • Note:—DMSO indicates dimethyl sulfoxide; DMI, dimethyl isosorbide; NMP, N-methyl-2-pyrollidone.

  • Table 2:

    Statistical analysis

    Solvents% of Vessel Narrowing at 3 minAverage % of Vessel Narrowing at 3 minVasospasm Score at 3 minAverage Vasospasm Score at 3 minAverage Duration of Vasospasm (min)
    DMSO50, 82, 36, 6859.02.5, 4, 2, 32.919.1
    Ethyl lactate50, 82, 40, 4253.52.5, 4, 2, 22.611.8
    Solketal50, 41, 53, 5950.82.5, 2, 3, 32.610.5
    Glycofurol65, 45, 21, 36, 3841.03, 2, 1, 2, 22.010.5
    DMI0, 32, 23, 39, 018.8*0, 2, 1, 2, 01.05.9*
    NMP28, 0, 14, 0, 17, 1011.5*2, 0, 1, 0, 1, 10.85.0*

    • Note:—DMSO indicates dimethyl sulfoxide; DMI, dimethyl isosorbide; NMP, N-methyl-2-pyrollidone.

    • * P < .05, Mann-Whitney test, comparison with corresponding values obtained for DMSO.

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Organic Solvents as Vehicles for Precipitating Liquid Embolics: A Comparative Angiotoxicity Study with Superselective Injections of Swine Rete Mirabile
O. Dudeck, O. Jordan, K.T. Hoffmann, A.F. Okuducu, K. Tesmer, T. Kreuzer-Nagy, D.A. Rüfenacht, E. Doelker, R. Felix
American Journal of Neuroradiology Oct 2006, 27 (9) 1900-1906;
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