Download PDF
Semin intervent Radiol 2023; 40(03): 315-322
DOI: 10.1055/s-0043-1769744
Back to Basics

Embolic Agents: Particles

Sean Lee
1   Touro College of Osteopathic Medicine, New York City, New York
,
Abheek Ghosh
2   Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
,
Nicholas Xiao
3   Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
,
Andrew C. Gordon
3   Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
,
Negar Heidarpour
1   Touro College of Osteopathic Medicine, New York City, New York
,
Brian Funaki
4   Division of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois
,
Robert J. Lewandowski
3   Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Compared with other embolic agents, particles offer distinct attributes for a broad range of clinical applications, including treatment of vascular tumors to achieving hemostasis in life-threatening emergencies.[1] Microparticle embolization is often the agent of choice when smaller, more distal vessels are targeted for occlusion. Due to their varied attributes, including size, shapes (i.e., microspheres), and material composition, particles can provide excellent versatility in embolization procedures. The aim of this article is to provide a back-to-the-basics overview of particle embolization. Here, we discuss the various microparticle types, their respective advantages and disadvantages, as well as technical considerations when using microparticles for embolization.



Publication History

Article published online:
20 July 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Karim V. Vascular and Interventional Radiology. Saunders/Elsevier: Philadelphia; 2006: 40-46
    Google Scholar
  • 2 Sheth RA, Sabir S, Krishnamurthy S. et al. Endovascular embolization by transcatheter delivery of particles: past, present, and future. J Funct Biomater 2017; 8 (02) 12
    CrossrefPubMedGoogle Scholar
  • 3 Guimaraes M. Does Material Matter? Particulate Embolics. Endovascular Today 2013 072013:4
    PubMedGoogle Scholar
  • 4 Doucet J, Kiri L, O'Connell K. et al. Advances in degradable embolic microspheres: a state of the art review. J Funct Biomater 2018; 9 (01) 14
    CrossrefPubMedGoogle Scholar
  • 5 Bilbao JI, de Luis E, García de Jalón JA. et al. Comparative study of four different spherical embolic particles in an animal model: a morphologic and histologic evaluation. J Vasc Interv Radiol 2008; 19 (11) 1625-1638
    CrossrefPubMedGoogle Scholar
  • 6 Xiao N, Lewandowski RJ. Embolic agents: coils. Semin Intervent Radiol 2022; 39 (01) 113-118
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Medsinge A, Zajko A, Orons P, Amesur N, Santos E. A case-based approach to common embolization agents used in vascular interventional radiology. AJR Am J Roentgenol 2014; 203 (04) 699-708
    CrossrefPubMedGoogle Scholar
  • 8 Abada HT, Golzarian J. Gelatine sponge particles: handling characteristics for endovascular use. Tech Vasc Interv Radiol 2007; 10 (04) 257-260
    CrossrefPubMedGoogle Scholar
  • 9 Poursaid A, Jensen MM, Huo E, Ghandehari H. Polymeric materials for embolic and chemoembolic applications. J Control Release 2016; 240: 414-433
    CrossrefPubMedGoogle Scholar
  • 10 Spies JB, Allison S, Flick P. et al. Polyvinyl alcohol particles and tris-acryl gelatin microspheres for uterine artery embolization for leiomyomas: results of a randomized comparative study. J Vasc Interv Radiol 2004; 15 (08) 793-800
    CrossrefPubMedGoogle Scholar
  • 11 Caine M, Carugo D, Zhang X, Hill M, Dreher MR, Lewis AL. Review of the development of methods for characterization of microspheres for use in embolotherapy: translating bench to Cathlab. Adv Healthc Mater 2017;6(09):
    PubMedGoogle Scholar
  • 12 Cziperle DJ. Avitene™ microfibrillar collagen hemostat for adjunctive hemostasis in surgical procedures: a systematic literature review. Med Devices (Auckl) 2021; 14: 155-163
    PubMedGoogle Scholar
  • 13 Patetta MA, Isaacson AJ, Stewart JK. Initial experience with HydroPearl microspheres for uterine artery embolization for the treatment of symptomatic uterine fibroids. CVIR Endovasc 2021; 4 (01) 32
    CrossrefPubMedGoogle Scholar
  • 14 Siskin GP, Dowling K, Virmani R, Jones R, Todd D. Pathologic evaluation of a spherical polyvinyl alcohol embolic agent in a porcine renal model. J Vasc Interv Radiol 2003; 14 (01) 89-98
    CrossrefPubMedGoogle Scholar
  • 15 Lewis AL, Dreher MR, O'Byrne V. et al. DC BeadM1™: towards an optimal transcatheter hepatic tumour therapy. J Mater Sci Mater Med 2016; 27 (01) 13
    CrossrefPubMedGoogle Scholar
  • 16 Lewis AL, Gonzalez MV, Leppard SW. et al. Doxorubicin eluting beads - 1: effects of drug loading on bead characteristics and drug distribution. J Mater Sci Mater Med 2007; 18 (09) 1691-1699
    CrossrefPubMedGoogle Scholar
  • 17 Lopera JE. Embolization in trauma: principles and techniques. Semin Intervent Radiol 2010; 27 (01) 14-28
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Katsumori T, Kasahara T. The size of gelatin sponge particles: differences with preparation method. Cardiovasc Intervent Radiol 2006; 29 (06) 1077-1083
    CrossrefPubMedGoogle Scholar
  • 19 Wang CY, Hu J, Sheth RA, Oklu R. Emerging embolic agents in endovascular embolization: an overview. Prog Biomed Eng (Bristol) 2020; 2 (01) 012003
    CrossrefPubMedGoogle Scholar
  • 20 Lencioni R, de Baere T, Burrel M. et al. Transcatheter treatment of hepatocellular carcinoma with Doxorubicin-loaded DC Bead (DEBDOX): technical recommendations. Cardiovasc Intervent Radiol 2012; 35 (05) 980-985
    CrossrefPubMedGoogle Scholar
  • 21 Jordan O, Denys A, De Baere T, Boulens N, Doelker E. Comparative study of chemoembolization loadable beads: in vitro drug release and physical properties of DC bead and hepasphere loaded with doxorubicin and irinotecan. J Vasc Interv Radiol 2010; 21 (07) 1084-1090
    CrossrefPubMedGoogle Scholar
  • 22 Liapi E, Lee KH, Georgiades CC, Hong K, Geschwind JF. Drug-eluting particles for interventional pharmacology. Tech Vasc Interv Radiol 2007; 10 (04) 261-269
    CrossrefPubMedGoogle Scholar
  • 23 Anderson ME, Kalva SP. Drug-eluting agents. In: Guimaraes M, Lencioni R, Siskin GP. eds. Embolization Therapy: Principles and Clinical Applications. Wolters Kluwer; 2014: 816
    Google Scholar
  • 24 Delicque J, Guiu B, Boulin M, Schwanz H, Piron L, Cassinotto C. Liver chemoembolization of hepatocellular carcinoma using TANDEM® microspheres. Future Oncol 2018; 14 (26) 2761-2772
    CrossrefPubMedGoogle Scholar
  • 25 Lazzaro MA, Badruddin A, Zaidat OO, Darkhabani Z, Pandya DJ, Lynch JR. Endovascular embolization of head and neck tumors. Front Neurol 2011; 2: 64
    CrossrefPubMedGoogle Scholar
  • 26 Borota L, Mahmoud E, Nyberg C, Lewén A, Enblad P, Ronne-Engström E. Dual lumen balloon catheter - an effective substitute for two single lumen catheters in treatment of vascular targets with challenging anatomy. J Clin Neurosci 2018; 51: 91-99
    CrossrefPubMedGoogle Scholar
  • 27 Smith SJ. Uterine fibroid embolization. Am Fam Physician 2000; 61 (12) 3601-3607 , 3611–3612
    PubMedGoogle Scholar
  • 28 Vo NJ, Andrews RT. Uterine artery embolization: a safe and effective, minimally invasive, uterine-sparing treatment option for symptomatic fibroids. Semin Intervent Radiol 2008; 25 (03) 252-260
    Article in Thieme ConnectPubMedGoogle Scholar
  • 29 Malone CD, Banerjee A, Alley MT, Vasanawala SS, Roberts AC, Hsiao A. Pelvic blood flow predicts fibroid volume and embolic required for uterine fibroid embolization: a pilot study with 4D flow MR angiography. AJR Am J Roentgenol 2018; 210 (01) 189-200
    CrossrefPubMedGoogle Scholar
  • 30 Lubarsky M, Ray C, Funaki B. Embolization agents-which one should be used when? Part 2: small-vessel embolization. Semin Intervent Radiol 2010; 27 (01) 99-104
    Article in Thieme ConnectPubMedGoogle Scholar
  • 31 Lubarsky M, Ray CE, Funaki B. Embolization agents-which one should be used when? Part 1: large-vessel embolization. Semin Intervent Radiol 2009; 26 (04) 352-357
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Ghosh A, Xiao N, Gordon AC, Funaki B, Lewandowski RJ. Embolic agents: vascular plugs. Semin Intervent Radiol 2022; 39 (05) 526-532
    Article in Thieme ConnectPubMedGoogle Scholar
  • 33 Lorenz J, Sheth D, Patel J. Bronchial artery embolization. Semin Intervent Radiol 2012; 29 (03) 155-160
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Johnson CG, Tang Y, Beck A. et al. Preparation of radiopaque drug-eluting beads for transcatheter chemoembolization. J Vasc Interv Radiol 2016; 27 (01) 117-126.e3
    CrossrefPubMedGoogle Scholar
  • 35 Dreher MR, Sharma KV, Woods DL. et al. Radiopaque drug-eluting beads for transcatheter embolotherapy: experimental study of drug penetration and coverage in swine. J Vasc Interv Radiol 2012; 23 (02) 257-64.e4
    CrossrefPubMedGoogle Scholar