PDF(Pubmed)
Abstract：
This review focuses on the use of conventional gel or coil and \"new\" generation hydrogel used as an embolic agent in endovascular applications. In general, embolic agents have deep or multidistrict vascular penetration properties as they ensure complete occlusion of vessels by exploiting the patient\'s coagulation system, which recognises them as substances foreign to the body, thus triggering the coagulation cascade. This is why they are widely used in the treatment of endovascular corrections (EV repair), arteriovenous malformations (AVM), endoleaks (E), visceral aneurysms or pseudo-aneurysms, and embolisation of pre-surgical or post-surgical (iatrogenic) lesions. Conventional gels such as Onyx or coils are now commercially available, both of which are frequently used in endovascular interventional procedures, as they are minimally invasive and have numerous advantages over conventional open repair (OR) surgery. Recently, these agents have been modified and optimised to develop new embolic substances in the form of hydrogels based on alginate, chitosan, fibroin and other polymers to ensure embolisation through phase transition phenomena. The main aim of this work was to expand on the data already known in the literature concerning the application of these devices in the endovascular field, focusing on the advantages, disadvantages and safety profiles of conventional and innovative embolic agents and also through some clinical cases reported. The clinical case series concerns the correction and exclusion of endoleak type I or type II appeared after an endovascular procedure of exclusion of aneurysmal abdominal aortic (EVAR) with a coil (coil penumbra released by a LANTERN microcatheter), the exclusion of renal arterial malformation (MAV) with a coil (penumbra coil released by a LANTERN microcatheter) and the correction of endoleak through the application of Onyx 18 in the arteries where sealing by the endoprosthesis was not guaranteed.
摘要：
这篇综述的重点是在血管内应用中使用常规凝胶或线圈和“新一代”水凝胶作为栓塞剂。总的来说,栓塞剂具有深或多区域血管穿透特性，因为它们通过利用患者的凝血系统确保血管完全闭塞，承认它们是身体外来的物质，从而触发凝血级联反应。这就是为什么它们被广泛用于血管内矫正（EV修复）的治疗，动静脉畸形（AVM），内漏(E),内脏动脉瘤或假性动脉瘤,术前或术后（医源性）病变的栓塞。传统的凝胶如Onyx或线圈现在是市售的，这两种方法经常用于血管内介入手术，因为它们具有微创性，并且比传统的开放修复（OR）手术具有许多优势。最近,这些药物已被修改和优化，以开发基于藻酸盐的水凝胶形式的新栓塞物质，壳聚糖,丝心蛋白和其他聚合物，以确保通过相变现象栓塞。这项工作的主要目的是扩大文献中已知的有关这些设备在血管内场应用的数据，注重优势,常规和创新栓塞剂的缺点和安全性以及一些临床病例的报道。临床病例系列涉及纠正和排除I型或II型内漏，这些内漏是在采用线圈（由LANTERN微导管释放的线圈半影）的腹主动脉瘤（EVAR）的血管内手术后出现的。用线圈(由LANTERN微导管释放的半影线圈)排除肾动脉畸形(MAV),并通过在不能保证内假体密封的动脉中应用Onyx18来矫正内漏。
