Percutaneous vein occlusion with small intestinal submucosa: An experimental pilot study in swine and sheep

Man Deuk Kim, Hanno Hoppe, Dusan Pavcnik, John A. Kaufman, Barry T. Uchida, Luiz O. Correa, Hans A. Timmermans, Won Kyu Park, Christopher L. Corless, Frederick S. Keller, Josef Rösch

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: The objective of this study was to investigate the feasibility, outcomes, and amount of small intestinal submucosa (SIS) material needed for embolization of jugular vein (JV) in a swine and sheep model. Our hypothesis was that SIS would cause vein occlusion. Materials and Methods: The external JVs (EJV) in swine (n = 6) and JVs in sheep (n = 6) were occluded with SIS fan-folded compressed strips. After percutaneous puncture of the peripheral portion of the EJV or JV, a TIPS set was used to exit their lumen centrally through the skin. The SIS strips were delivered into the isolated venous segment with a pull-through technique via a 10-Fr sheath. Follow-up venograms were done immediately after placement and at the time of sacrifice at 1 or 3 months. Gross examinations focused on the EJV or JV and their surrounding structures. Specimens were evaluated by histology. Results: SIS strip(s) placement was successful in all cases, with immediate vein occlusion seen in 23 of 24 veins (95.8%). All EJVs treated with two strips and all JVs treated with three or four strips remained closed on 1- and 3-month follow-up venograms. Two EJVs treated with one strip and one JV treated with two strips were partially patent on venograms at 1 and 3 months. There has been one skin inflammatory reaction. Necropsies revealed excluded EJV or JV segments with SIS incorporation into the vein wall. Histology demonstrated various stages of SIS remodeling with fibrocytes, fibroblasts, endothelial cells, capillaries, and inflammatory cells. Conclusion: We conclude that EJV and JV ablation with SIS strips using percutaneous exit catheterization is feasible and effective in animal models. Further exploration of SIS as vein ablation material is recommended.

Original languageEnglish (US)
Pages (from-to)725-730
Number of pages6
JournalCardiovascular and interventional radiology
Volume30
Issue number4
DOIs
StatePublished - Jul 1 2007

Keywords

  • Ablation
  • Animal model
  • Biomaterial
  • Embolization
  • Varicose veins

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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