P-028 Ophthalmic artery flow direction changes in intra-arterial treatment of retinoblastoma

Abstract

cytotoxicity of organic solvents (e.g., Dimethyl Sulfoxide (DMSO)). Aqua Embolic System (AES) is a new LEM, which is mainly composed of multiple polysaccharides. AES, when injected via a microcatheter, immediately forms a solid and elastic hydrogel cast upon exposure to Ca2+ in the bloodstream. The use of organic solvents, e.g., DMSO, is not required. The performance of AES was evaluated using an established AVM model utilizing swine rete-mirabile. Methods Under general anesthesia, the left ascending pharyngeal artery (APA) of Yorkshire swine (40 kg) was catheterized using a microcatheter (ID:0.013 inches), and AES was slowly injected into the rete-mirabile under fluoroscopy. The following parameters were assessed to evaluate the embolization performance of the AES; 1) the amount of AES required for the complete occlusion of the feeding artery, 2) injection speed, 3) radiopacity during the deployment, and 4) incidence of catheter entrapment after the injection. The same evaluation was performed on the contralateral rete-mirabile and the left renal artery as well. Results 12 arteries in 4 swine were treated, and all arteries were completely occluded without technical complications. The injected materials immediately formed AES cast in all vessels, followed by the reflux over the tip of the microcatheter. All catheters were withdrawn without any sign of catheter entrapment. The AES mixed with tantalum-based contrasts medium showed sufficient radiopacity under fluoroscopy. With the injection speed of 0.02ml/sec, the average volume required was 0.85mL for the APA and 2.9mL for the renal artery. No increased thrombogenicity or vasospasm near the treated lesion was observed during the procedure. Conclusions AES, which is a DMSO free, non-adhesive polysaccharides based LEM, may be used as an embolic material for the treatment of hemorrhagic stroke caused by cerebrovascular diseases, such as brain AVM.A: common carotid artery injection (AP view) shows left ascending pharyngeal artery (APA) and left rete mirabile (red arrow). B: AES is injected from the microcatheter. The AES reflux is reaching the tip of the microcatheter. C: With continuous injection of AES, the microcotheter tip is embedded ¡n the cost of AES. D. Post treatment angiogram shows complete occlusion of the left rete mirabile and APA Disclosures I.

Absorbable gelatin compressed sponge (Gelfoam) embolization of distal external carotid artery branches in intra-arterial chemotherapy for retinoblastoma

“…Once stability is achieved, and before proceeding with injection of the chemotherapy, an acceptable choroidal blush has to be obtained regardless of the presence or not of an ICA reflux during OA opacification11 (knowing that in some cases with anatomical variants such as a MMA arising from the lacrimal artery, a vascular steal can lead to a poor tumor response despite an acceptable choroidal blush 12. The choroidal blush through the OA may be absent or not convincing, and this can be explained by a competitive backflow from the ECA into the OA due to the hemodynamic balance between the ICA and ECA 13…”