Solid Tumor Embolotherapy in Hepatic Arteries with an Anti-reflux Catheter System

Ann Biomed Eng. 2016 Apr;44(4):1036-46. doi: 10.1007/s10439-015-1411-7. Epub 2015 Aug 12.

Abstract

Unresectable hepatoma accounts for the majority of malignant liver tumor cases for which embolization therapy is considered a viable treatment option. However, the potential risk of aberrant particle deposition in non-target regions could cause severe side-effects, alongside diminished efficacy. A computational model has been developed to analyze the particle-hemodynamics before and after deployment of an FDA-approved anti-reflux catheter. The catheter features a retractable, porous cone-like tip designed to allow forward blood flow while preventing microsphere reflux. A patient-specific hepatic artery system, with different daughter branches connected to a liver tumor, was chosen as a representative test bed. In vitro as well as in vivo measurements were used to validate the computer simulation model. The model captures the effect of tip-deployment on blood perfusion and pressure drop in an interactive manner under physiologically realistic conditions. A relationship between the pressure drop and embolization level was established, which can be used to provide clinicians with real-time information on the best infusion-stop point. However, the results show that the present procedure for embolization of downstream vessels which feed a tumor is quite arbitrary. Nevertheless, a method to recycle aberrant particles captured by the deployed tip was proposed to minimize side-effects.

Keywords: Embolization; Excessive particle capture; Infusion-stop point; Liver cancer; Particle-reflux; Transient particle-hemodynamics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Pressure
  • Carcinoma, Hepatocellular / therapy*
  • Catheters
  • Embolization, Therapeutic*
  • Hemodynamics
  • Hepatic Artery / physiology*
  • Humans
  • Liver Neoplasms / therapy*
  • Microspheres
  • Models, Biological*