In Vivo Feasibility of Arterial Embolization with a New Permanent Agar–agar-Based Agent

Purpose

Evaluate the safety and efficacy of an eco-friendly permanent agar–agar-based embolization agent (ABEA) (EmboBio®) for intra-arterial use.

Materials and Methods

Six pigs embolized with one ABEA torpedo (6 lower polar renal and 6 lumbar arteries) and one coil (6 lower polar renal and 6 lumbar arteries).

Technical success was defined as a complete occlusion with no residual flow in DSA. Short-term endpoints included safety (non-targeted embolization), ease of use (embolization preparation time, occlusion time), and DSA controls at day 7, month 1, and month 3.

Tissue reaction was assessed via [18F]-FDG PET/CT at month 2 and histological study at month 3.

Results

ABEA torpedoes achieved immediate and persistent occlusion at month 3 for all kidney and lumbar embolizations (n = 12/12).

Control coils had technical success for 12/12, with a persistent occlusion at month 3 for 2/12.

No off-target embolization occurred.

ABEA torpedoes demonstrate faster occlusion (ABEA: 6 ± 4 s; coils: 427 ± 469 s; p = 0.0022, n = 12) and preparation times (ABEA: 96.9 1 ± 23 s; coils: 150.33 ± 58 s; p = 0.0432, n = 12) after device placement than coil.

No significant difference in inflammation between ABEA and coil groups at month 2 (ABEA: 3.35e⁻⁶ ± 1.7e⁻⁶%ID/mm³; coils: 2.24e⁻⁶ ± 8.5e⁻⁷%ID/mm3; p = 0.5) on PET imaging. These results were confirmed by histological analysis at month 3.

Conclusion

Permanent dry foam torpedo comprising agar–agar is effective for arterial embolization. In animal model, one ABEA torpedo demonstrates a faster and more persistent occlusion than one fiber coil.

Levels of Evidence

Not applicable.

Graphical Abstract