TY - JOUR
T1 - Embolic Characteristics of Imipenem-Cilastatin Particles in Vitro and in Vivo
T2 - Implications for Transarterial Embolization in Joint Arthropathies
AU - Yamada, Kentaro
AU - Jahangiri, Younes
AU - Li, Jianjun
AU - Gabr, Ahmed
AU - Anoushiravani, Arianna
AU - Kumagai, Kosuke
AU - Uchida, Barry
AU - Farsad, Khashayar
AU - Horikawa, Masahiro
N1 - Publisher Copyright:
© 2021 SIR
PY - 2021/7
Y1 - 2021/7
N2 - Purpose: To elucidate in vitro and in vivo characteristics and embolic properties of imipenem-cilastatin (IPM-CS) compared with hydrogel microspheres. Materials and Methods: Particle size distribution was microscopically evaluated with 3 samples of 50 mg IPM-CS suspensions in each of 6 conditions by a mixture of contrast volume: 500 or 1000 μL and vortex mixing time: 5, 10, or 30 s. Time-dependent changes up to 3 h post-mixing were also evaluated. Fifteen male Sprague-Dawley rats (460.2 ± 5.0 g) underwent unilateral renal artery embolization using IPM-CS (n = 11) or hydrogel microspheres (n = 4). Follow-up angiography 48 h after embolization and histological evaluation, including acute tubular necrosis (ATN) and inflammation, were scored using a 5-point scale (from 0 = normal to 4 = severe). Results: Over 91% of IPM-CS particles were <40 μm under all in vitro conditions. With the increased contrast volume, the average particle size also increased (mean ± standard deviation: 11.6 ± 13.9 vs 16.7 ± 18.2 μm for 500 and 1000 μL iodinated contrast, P < .001); however, the impact of the mixing/elapsed time were limited. At 48 h after embolization, all cases in the IPM-CS groups (11/11) showed major to complete recanalization versus no recanalization with hydrogel microspheres (0/4) (P < .001). The following are the median ATN and inflammation grades in the cortex (ventral/dorsal) and medulla (ventral/dorsal) in both groups: IPM-CS, ATN in cortex (2/4) and medulla (1/1), inflammation in cortex (0/0) and medulla (0/0); hydrogel microspheres, ATN in cortex (4/4) and medulla (3/2), inflammation in cortex (1/1) and medulla (1/1). Conclusions: IPM-CS suspension generated particles that were predominantly smaller than 40 μm and with unique short-term embolic effects, leaving predominantly peripheral ischemic changes.
AB - Purpose: To elucidate in vitro and in vivo characteristics and embolic properties of imipenem-cilastatin (IPM-CS) compared with hydrogel microspheres. Materials and Methods: Particle size distribution was microscopically evaluated with 3 samples of 50 mg IPM-CS suspensions in each of 6 conditions by a mixture of contrast volume: 500 or 1000 μL and vortex mixing time: 5, 10, or 30 s. Time-dependent changes up to 3 h post-mixing were also evaluated. Fifteen male Sprague-Dawley rats (460.2 ± 5.0 g) underwent unilateral renal artery embolization using IPM-CS (n = 11) or hydrogel microspheres (n = 4). Follow-up angiography 48 h after embolization and histological evaluation, including acute tubular necrosis (ATN) and inflammation, were scored using a 5-point scale (from 0 = normal to 4 = severe). Results: Over 91% of IPM-CS particles were <40 μm under all in vitro conditions. With the increased contrast volume, the average particle size also increased (mean ± standard deviation: 11.6 ± 13.9 vs 16.7 ± 18.2 μm for 500 and 1000 μL iodinated contrast, P < .001); however, the impact of the mixing/elapsed time were limited. At 48 h after embolization, all cases in the IPM-CS groups (11/11) showed major to complete recanalization versus no recanalization with hydrogel microspheres (0/4) (P < .001). The following are the median ATN and inflammation grades in the cortex (ventral/dorsal) and medulla (ventral/dorsal) in both groups: IPM-CS, ATN in cortex (2/4) and medulla (1/1), inflammation in cortex (0/0) and medulla (0/0); hydrogel microspheres, ATN in cortex (4/4) and medulla (3/2), inflammation in cortex (1/1) and medulla (1/1). Conclusions: IPM-CS suspension generated particles that were predominantly smaller than 40 μm and with unique short-term embolic effects, leaving predominantly peripheral ischemic changes.
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U2 - 10.1016/j.jvir.2021.02.006
DO - 10.1016/j.jvir.2021.02.006
M3 - Article
C2 - 33607251
AN - SCOPUS:85106577972
SN - 1051-0443
VL - 32
SP - 1031-1039.e2
JO - Journal of Vascular and Interventional Radiology
JF - Journal of Vascular and Interventional Radiology
IS - 7
ER -