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Evaluation of arterial impairment after experimental gelatin sponge embolization in a rabbit renal model.

Oh JS, Lee HG, Chun HJ, Choi BG, Choi YJ - Korean J Radiol (2015)

Bottom Line: Gelatin sponge particles were mainly observed in the segmental and interlobar arteries.Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina.The migrating smooth muscle cells were distributed around the recanalized arterial lumen.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

ABSTRACT

Objective: Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model.

Materials and methods: A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were performed on hematoxylin-eosin and smooth muscle actin immunohistochemical stained sections.

Results: Gelatin sponge particles were mainly observed in the segmental and interlobar arteries. Transmural inflammation of the embolized arterial wall and mild thickening of the media were observed 1 week after embolization. Resorption of the gelatin sponge and organization of thrombus accompanied by foreign body reactions, were observed from 2 to 4 weeks after embolization. Microscopic images of the 3 weeks group showed vessel lumens filled mostly with organized thrombi, resulting in severe stenosis. Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina. The migrating smooth muscle cells were distributed around the recanalized arterial lumen.

Conclusion: Gelatin sponge embolization may induce arterial stenosis by causing organized thrombus and intimal hyperplasia, which consists of migrating smooth muscle cells and intimal collagen deposits.

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Related in: MedlinePlus

Microscopic image of interlobar artery 4 weeks after embolization with gelatin sponge particles. There are no inflammatory cells. Completely organized thrombus attached to vessel wall, and decreased proliferation of smooth muscle cells in media is observed. Internal elastic lamina has multifocal loss of continuity (arrows) (immunohistochemical staining for smooth muscle actin, original magnification × 20).
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Figure 4: Microscopic image of interlobar artery 4 weeks after embolization with gelatin sponge particles. There are no inflammatory cells. Completely organized thrombus attached to vessel wall, and decreased proliferation of smooth muscle cells in media is observed. Internal elastic lamina has multifocal loss of continuity (arrows) (immunohistochemical staining for smooth muscle actin, original magnification × 20).

Mentions: Most embolized arteries showed partial resorption of GSPs and a foreign body reaction with giant cells, after 2 weeks. There was focal dehiscence with propagation of transmural inflammation to the internal elastic lamina. In some vessels, there was destruction of all 3 layers of the wall due to severe transmural inflammation (Fig. 2). Angiography showed partial recanalization of the larger sections of the target arteries, with mild luminal irregularities. The GSPs were completely resorbed after 3 weeks. The vessel lumens were mostly filled with organized thrombi, and the recanalized arterial lumens were lined with migrating smooth muscle cells. Some small intraluminal collaterals had developed in the organized thrombi. Immunohistochemical staining for smooth muscle actin showed proliferation of smooth muscle cells in the media, thickened intima with migration of smooth muscle cells from the media, and interruption of the internal elastic lamina. The arteries with intimal thickening and severe organized thrombi had decreased luminal diameters. The migrating smooth muscle cells were mainly distributed around the recanalized arterial lumens. Angiography of the recanalized arteries showed diffuse luminal narrowing and multifocal stenosis (Fig. 3). The inflammation had subsided, and there were completely organized thrombi attached to the vessel wall after 4 weeks. There was multifocal loss of continuity of the internal elastic lamina, and the proliferation of smooth muscle cells had decreased (Fig. 4). The histological findings were shown in Table 1.


Evaluation of arterial impairment after experimental gelatin sponge embolization in a rabbit renal model.

Oh JS, Lee HG, Chun HJ, Choi BG, Choi YJ - Korean J Radiol (2015)

Microscopic image of interlobar artery 4 weeks after embolization with gelatin sponge particles. There are no inflammatory cells. Completely organized thrombus attached to vessel wall, and decreased proliferation of smooth muscle cells in media is observed. Internal elastic lamina has multifocal loss of continuity (arrows) (immunohistochemical staining for smooth muscle actin, original magnification × 20).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296261&req=5

Figure 4: Microscopic image of interlobar artery 4 weeks after embolization with gelatin sponge particles. There are no inflammatory cells. Completely organized thrombus attached to vessel wall, and decreased proliferation of smooth muscle cells in media is observed. Internal elastic lamina has multifocal loss of continuity (arrows) (immunohistochemical staining for smooth muscle actin, original magnification × 20).
Mentions: Most embolized arteries showed partial resorption of GSPs and a foreign body reaction with giant cells, after 2 weeks. There was focal dehiscence with propagation of transmural inflammation to the internal elastic lamina. In some vessels, there was destruction of all 3 layers of the wall due to severe transmural inflammation (Fig. 2). Angiography showed partial recanalization of the larger sections of the target arteries, with mild luminal irregularities. The GSPs were completely resorbed after 3 weeks. The vessel lumens were mostly filled with organized thrombi, and the recanalized arterial lumens were lined with migrating smooth muscle cells. Some small intraluminal collaterals had developed in the organized thrombi. Immunohistochemical staining for smooth muscle actin showed proliferation of smooth muscle cells in the media, thickened intima with migration of smooth muscle cells from the media, and interruption of the internal elastic lamina. The arteries with intimal thickening and severe organized thrombi had decreased luminal diameters. The migrating smooth muscle cells were mainly distributed around the recanalized arterial lumens. Angiography of the recanalized arteries showed diffuse luminal narrowing and multifocal stenosis (Fig. 3). The inflammation had subsided, and there were completely organized thrombi attached to the vessel wall after 4 weeks. There was multifocal loss of continuity of the internal elastic lamina, and the proliferation of smooth muscle cells had decreased (Fig. 4). The histological findings were shown in Table 1.

Bottom Line: Gelatin sponge particles were mainly observed in the segmental and interlobar arteries.Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina.The migrating smooth muscle cells were distributed around the recanalized arterial lumen.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701, Korea.

ABSTRACT

Objective: Arterial stenosis is a major obstacle for subsequent interventional procedures. We hypothesized that the stenosis is caused by gelatin sponge embolization and performed an experimental study in a rabbit renal model.

Materials and methods: A total of 24 rabbits were embolized with porcine gelatin sponge particles injected into the renal arteries. Four rabbits were sacrificed on 1 day, 4 days, 1 week, 2 weeks, 3 weeks, and 4 weeks after embolization. Microscopic evaluations were performed on hematoxylin-eosin and smooth muscle actin immunohistochemical stained sections.

Results: Gelatin sponge particles were mainly observed in the segmental and interlobar arteries. Transmural inflammation of the embolized arterial wall and mild thickening of the media were observed 1 week after embolization. Resorption of the gelatin sponge and organization of thrombus accompanied by foreign body reactions, were observed from 2 to 4 weeks after embolization. Microscopic images of the 3 weeks group showed vessel lumens filled mostly with organized thrombi, resulting in severe stenosis. Additionally, vessels showed a thickened intima that contained migrating smooth muscle cells and accompanying interruption of the internal elastic lamina. The migrating smooth muscle cells were distributed around the recanalized arterial lumen.

Conclusion: Gelatin sponge embolization may induce arterial stenosis by causing organized thrombus and intimal hyperplasia, which consists of migrating smooth muscle cells and intimal collagen deposits.

Show MeSH
Related in: MedlinePlus