63 - Biodegradable Materials Available for Transarterial Embolization
T. Garg, A. Khalil, P. Gowda, A. J. Gong, R. Weinstein, C. R. Weiss
Purpose: To review all available novel biodegradable occlusion technologies for vascular embolization and compare their properties and preclinical data to provide a reference for interventional radiologists interested in this field.
Material and Methods: Over the last decade, there has been increased interest in the development of biodegradable embolic agents for transarterial embolization (TAE) procedures. The goal of degradable embolic agents is to provide effective embolization on a transient basis. These embolic agents are removed from the body after achieving the intended clinical outcome without interfering with the function of other organs. Removing these agents will potentially minimize long-term sequelae of permanent embolic agents like alternations in histological architecture, vascular capacitance, and injury to tissue due to “on” or “off” target deposition.
Results: An ideal biodegradable embolic should have tailored degradation timeframes, a variety of tightly calibrated particle size distributions, easily suspendable in physiological solutions, easy delivery through traditional microcatheters, full biological compatibility, and multi-modal imageability. The degradation of microspheres can occur due to enzymatic reactions or hydrolysis. When new biomaterials are developed, their preclinical safety and efficacy are evaluated in accordance with the Vascular and Neurovascular Embolization Devices guidance document published by the Food and Drug Administration.
In development and currently available degradable occlusion agents are Gelatin (Gelfoam), Starch (Embocept), polylactic-co-glycolic acid (PLGA, Occlusin 500), Cellulose/ Chitosan (Resosphere), Hydroxyethyl acrylate (HEA, Biosphere Medical), Polycarbonate, Poly-methyl acrylate (Occlugel). In this exhibit, we will discuss their basic chemistry, mechanism of degradation, data on safety, efficacy, and performance, and advantages, disadvantages of each agent.
Conclusions: The materials available for embolization have evolved rapidly in the last few decades from autologous blood clots, and muscle tissues to microspheres and gels made up of complex polymers that can be modified for a wide array of functions. The clinical application and development of new agents will continue to expand as the field of endovascular intervention grows.