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1.
Poult Sci ; 103(7): 103768, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38703758

RESUMO

Baicalein (BAI) is a natural flavonoid with antioxidant, antitumor and antibacterial properties. However, the bioavailability of BAI was limited due to low solubility. This study aims to improve the solubility of BAI through the amorphous solid dispersion (ASD) and evaluate changes in its pharmacokinetics and pharmacodynamics in Taihang chickens. Polyethylene caprolactam-polyvinyl acetate-polyethylene glycol grafted copolymer (Soluplus) was chosen as the carrier, and ASD was prepared by rotary evaporation and was characterized by powder X-ray diffractions (PXRD), differential scanning calorimetry (DSC) and fourier transform infrared spectroscopy (FT-IR). In vitro dissolution assays were used to screen the optimal ratio of drug to carrier, in vivo pharmacokinetic assays were conducted to investigate the promoting effect on the absorption. In addition, the effects of ASD on the growth performance, meat quality, antioxidant capacity and intestinal flora were investigated. ASD (1:9 and 2:8) did not exhibit crystal diffraction peaks of BAI in PXRD or endothermic peaks in DSC, indicating the successful preparation of ASD. The results of in vitro dissolution assay showed that the cumulative dissolution rate of ASD (2:8) within 600 min was 52.67%, which was 7.84-fold higher than BAI. The pharmacokinetic results showed that the peak concentration (Cmax) and the area under the drug-time curve (AUC0∼24) of ASD (2:8) was (5.20 ± 0.82) µg/mL and (17.03 ± 0.67) µg·h/mL, which was 1.91 and 2.64-fold higher than BAI, respectively. Dietary supplementation of BAI and ASD could increase average daily gain (ADG), while decrease feed conversion ratio (FCR), but there was no significant difference (P > 0.05). The drip loss of BAIASD group was lower than BAI group (P < 0.05). In addition, the antioxidant capacity of Taihang chickens were enhanced, the diversity and the abundance of beneficial bacteria was improved. Results of BAI upon the dietary supplementation tested in Taihang chickens, after preparation of ASD, indicating a superior enhancement effect in growth performance, meat quality, antioxidant capacity and intestinal flora due to an improved solubility and optimized bioavailability.


Assuntos
Ração Animal , Antioxidantes , Disponibilidade Biológica , Galinhas , Dieta , Flavanonas , Microbioma Gastrointestinal , Carne , Solubilidade , Animais , Galinhas/crescimento & desenvolvimento , Antioxidantes/metabolismo , Flavanonas/administração & dosagem , Flavanonas/química , Flavanonas/farmacologia , Carne/análise , Ração Animal/análise , Microbioma Gastrointestinal/efeitos dos fármacos , Dieta/veterinária , Polivinil/química , Polivinil/administração & dosagem , Masculino , Polietilenoglicóis/química , Polietilenoglicóis/administração & dosagem , Suplementos Nutricionais/análise
3.
J Vasc Surg ; 74(3): 1024-1032, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33940072

RESUMO

OBJECTIVE: The long-term success of endovascular aneurysm repair (EVAR) is limited by complications, most importantly endoleaks. In case of (persistent) type I endoleak (T1EL), secondary intervention is indicated to prevent secondary aneurysm rupture. Different treatment options are suggested for T1ELs, such as endo anchors, (fenestrated) cuffs, embolization, or open conversion. Currently, the treatment of T1EL with liquid embolic agents is available; however, results are not yet addressed. This review presents the safety and efficacy of embolization with liquid embolic agents for treatment of T1ELs after EVAR. METHODS: A systematic literature search was performed for all studies reporting the use of liquid embolic agents as monotherapy for treatment of T1ELs after EVAR. Patient numbers, technical success (successful delivery of liquid embolics in the T1EL) and clinical success (absence of aneurysm related death, endoleak recurrence or additional interventions during follow-up) were examined. RESULTS: Of 1604 articles, 10 studies met the selection criteria, including 194 patients treated with liquid embolics; 73.2% of the patients were male with a median age of 71 years. The overall technical success was 97.9%. Clinical success was 87.6%. Because the median follow-up was only 13.0 months (range, 1-89 months), data on long-term success are almost absent. Four cases (2.1%) of secondary aneurysm rupture after embolization owing to endoleak recurrence were reported. All ruptures occurred in aneurysms exceeding initial treatment diameter of 70 mm. CONCLUSIONS: Initial technical success after liquid embolization for T1EL is high, although long-term clinical success rates are lacking. Within this review, the risk of secondary rupture is comparable with untreated T1EL at 2% with a median follow-up of 13 months, regardless of the initial success of embolization. In general, no decrease in secondary aneurysm rupture after embolization of T1EL after EVAR is demonstrated, although the results of late embolization are debated.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Embolização Terapêutica , Endoleak/terapia , Procedimentos Endovasculares/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/mortalidade , Implante de Prótese Vascular/mortalidade , Dimetil Sulfóxido/administração & dosagem , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/mortalidade , Embucrilato/administração & dosagem , Endoleak/diagnóstico por imagem , Endoleak/etiologia , Endoleak/mortalidade , Procedimentos Endovasculares/mortalidade , Feminino , Humanos , Masculino , Polivinil/administração & dosagem , Medição de Risco , Fatores de Risco , Trombina/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
5.
J Neurointerv Surg ; 13(7): 657-660, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33077579

RESUMO

BACKGROUND: Recently, middle meningeal artery (MMA) embolization has emerged as a potentially safe and effective method of treating chronic subdural hematoma (cSDH). OBJECTIVE: To report a single-center experience with MMA embolization and examines the type of embolic material used, the extent of penetration, and the number of MMA branches embolized. METHODS: A retrospective analysis of all patients with MMA embolization from 2018 through 2019 was performed. A failed outcome was defined as either surgical rescue and/or greater than 10 mm of hematoma residual or reaccumulation following embolization. RESULTS: Of 35 patients, surgery had failed for 9 (26%) and initial conservative treatment had failed for 6 (17%). Of 41 MMA embolizations, including those in six patients with bilateral cSDH who underwent bilateral MMA embolization, 29 (72%) were performed using ethylene vinyl alcohol copolymer (Onyx), 7 (17%) using particles, and 5 (12%) using n-butyl cyanoacrylate. Both the anterior and posterior MMA divisions were embolized in 29 cases (71%); distal penetration of these branches was achieved in 25 embolizations (61%). Twenty-six (63%) cSDHs completely resolved. Complete resolution was seen in 22 of 29 hematomas (76%) in which both anterior and posterior MMA branches were occluded versus 4 of 12 (33%) following single-branch embolization (p=0.014). Embolization of one cSDH (2%) failed. CONCLUSION: MMA embolization of cSDHs appears to be both safe and efficacious. Furthermore, embolization of both the anterior and posterior MMA branches may be associated with increased odds of complete resolution.


Assuntos
Embolização Terapêutica/métodos , Embucrilato/administração & dosagem , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/terapia , Artérias Meníngeas/diagnóstico por imagem , Polivinil/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Feminino , Hematoma Subdural Crônico/cirurgia , Humanos , Masculino , Artérias Meníngeas/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
Vasc Endovascular Surg ; 55(1): 50-57, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33043841

RESUMO

INTRODUCTION: This study reports our experience with the use of an ethylene vinyl alcohol copolymer (Onyx™) for the treatment of type II endoleak after endovascular repair of abdominal aortic aneurysms (EVAR) in comparison to coils and cyanoacrylate glue. METHODS: Clinical data of all patients treated for type II endoleak following EVAR between 2009 and 2017 were retrospectively analyzed. Abdominal aortic aneurysm (AAA) diameter and AAA sac volume during follow-up were measured using computed tomography angiography (CTA). Treatment failure variables were created for the change in sac diameter and volume. An increase in sac diameter ≥ 5 mm was considered a failure, as was an increase ≥ 10% in AAA sac volume. RESULTS: 35 patients underwent treatment for a persistent type II endoleak following EVAR. Of these patients, 18 (51.4%) were treated with Onyx and 17 (48.6%) were treated with coils ± cyanoacrylate glue embolization. There were no significant differences between the 2 groups with regard to demographics. The average volume of Onyx used per treatment was 13.4 ml (range 4.5 ml- 39 ml). There was no difference in efficacy between the Onyx and non-Onyx group. Complications were limited to 1 non-target embolization without significant clinical sequelae. CONCLUSIONS: Ethylene vinyl alcohol copolymer (Onyx™) embolization is similarly effective compared to traditional cyanoacrylate glue or coil embolization in the treatment of type II endoleak after EVAR.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Cianoacrilatos/administração & dosagem , Embolização Terapêutica , Endoleak/terapia , Procedimentos Endovasculares/efeitos adversos , Polivinil/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Cianoacrilatos/efeitos adversos , Embolização Terapêutica/efeitos adversos , Embolização Terapêutica/instrumentação , Endoleak/diagnóstico por imagem , Endoleak/etiologia , Feminino , Humanos , Masculino , Polivinil/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
7.
J Neurointerv Surg ; 13(3): 261-266, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32546639

RESUMO

BACKGROUND: Balloon-assisted techniques can improve the endovascular treatment of cerebrospinal vascular malformations. The aim of this study was to report the first clinical multicenter experience with the new Scepter Mini dual-lumen microballoon catheter. METHODS: Patients with cerebral or spinal vascular malformations treated with the Scepter Mini at seven European neurovascular centers were retrospectively reviewed. Clinical data, angiographic features of the vascular malformations, procedural parameters including the type of application, navigability, technical failures, complications and embolization success were assessed. RESULTS: The usage of 34 Scepter Mini microballoon catheters in 20 patients was analyzed. Most treated malformations (80.0%) were cerebral arteriovenous malformations. Four different applications were reported: embolization via Scepter Mini (n=23, 67.6%), balloon-occlusion with simultaneous embolization via a second microcatheter (n=3, 8.8%), diagnostic angiography with simultaneous balloon-inflation for flow arrest (n=4, 11.8%), and navigation support (n=4, 11.8%). The mean diameter of the blood vessels in which the Scepter Mini was inflated was 1.9±0.5 mm. The navigability of the Scepter Mini was rated as 'easy' or 'very easy' in 88.2% of cases. Complete occlusion of the malformation was achieved in 60.9% of cases. Technical failures occurred in 4/23 embolization procedures, and all were related to insufficient stability of the balloon within the vessel. No complications related to the Scepter Mini were observed, while unrelated complications occurred in three patients (15.0%). CONCLUSIONS: The Scepter Mini is a promising new device for balloon-assisted embolization of cerebrospinal vascular malformations via small feeders. Beyond embolization, the Scepter Mini can also be used for other applications, such as superselective flow arrest and navigation support.


Assuntos
Oclusão com Balão/métodos , Catéteres , Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/cirurgia , Embolização Terapêutica/métodos , Adulto , Angiografia/métodos , Oclusão com Balão/instrumentação , Embolização Terapêutica/instrumentação , Feminino , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/cirurgia , Masculino , Pessoa de Meia-Idade , Polivinil/administração & dosagem , Estudos Retrospectivos , Resultado do Tratamento
8.
J Vasc Surg ; 73(6): 1966-1972, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33249208

RESUMO

OBJECTIVE: Little evidence is available supporting the optimal treatment of type II endoleaks associated with aortic sac growth. Previous studies have lacked comparisons between treatment methods and long-term follow-up. The purpose of the present study was to review our center's experience with the treatment of type II endoleaks comparing Onyx (a liquid embolization agent consisting of ethylene vinyl alcohol; Medtronic, Minneapolis, Minn) embolization and coil embolization. METHODS: A retrospective review of prospectively collected data from a vascular surgery database was performed to identify all patients who had undergone embolization of a type II endoleak for aortic sac growth after endovascular aneurysm repair from 2005 to 2018. The Onyx and coil embolization groups were compared using univariate statistics. RESULTS: A total of 58 patients had undergone 77 embolization procedures for type II endoleaks with either Onyx (27 patients; 37 procedures) or coils (31 patients; 40 procedures). The average aneurysm size at embolization was larger in the Onyx group (77.9 ± 15.1 mm) compared with coil embolization (73.4 ± 11.9 mm). The mean follow-up was 57 months for the Onyx group and 74 months for the coil embolization group. Of the 27 patients who had undergone Onyx embolization, 2 (7.4%) had required graft explantation compared with 5 of the 31 patients (16.1%) who had undergone coil embolization (P = .33). The results of the per-patient analysis showed that the coil embolization group had a significantly greater rate of the need for further reintervention compared with the Onyx group (55% vs 19%; P < .01). Clinical success was observed in 13 patients (48%) in the Onyx embolization group compared with 10 patients (32%) in the coil embolization group (P = .04). Two patients in each group had presented with secondary rupture of the aneurysm sac after attempted embolization. CONCLUSIONS: Type II endoleaks associated with sac growth treated with Onyx were less likely to require further reinterventions than were those treated with coil embolization. A trend was found toward a greater need for endovascular aneurysm repair explant after coil embolization. With a high rate of further reintervention and potential for sac rupture, diligent follow-up is required after attempted type II embolization, regardless of the technique used.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Dimetil Sulfóxido/administração & dosagem , Embolização Terapêutica/instrumentação , Endoleak/terapia , Procedimentos Endovasculares/efeitos adversos , Polivinil/administração & dosagem , Bases de Dados Factuais , Dimetil Sulfóxido/efeitos adversos , Embolização Terapêutica/efeitos adversos , Endoleak/diagnóstico por imagem , Endoleak/etiologia , Feminino , Humanos , Masculino , Polivinil/efeitos adversos , Retratamento , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
9.
Vascular ; 29(3): 404-407, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33028161

RESUMO

OBJECTIVES: The aim of this article is to report an alternative approach for the management of a distal aneurysm of superior mesenteric artery using direct percutaneous ultrasound-guided Onyx injection. METHODS: We report a rare case of symptomatic superior mesenteric artery aneurysm. A 78-year-old man presents with pain and pulsating mass in the right umbilical region of the abdomen. The patient was treated by percutaneous ultrasound-guided Onyx injection after several failing transarterial embolization attempts. RESULTS: The procedure was successful without any complication, and the patient wasdischarged to home the day after procedure. Follow-up at 60 months confirmed the complete thrombosis of the aneurysm sac. Ultrasound-guided Onyx injection for distal superior mesenteric artery aneurysm could provide an alternative to transcatheter arterial embolization or open surgery. Anatomical assessment of collaterals and knowledge of abdomen anatomy could play important roles in preventing bowel ischemia and minimizing the risk of procedural complication. CONCLUSION: Ultrasound-guided Onyx injection of superior mesenteric artery aneurysm is a feasible, effective, and cost-saving technique that can be used when endovascular approach is not possible or has failed.


Assuntos
Aneurisma/terapia , Dimetil Sulfóxido/administração & dosagem , Embolização Terapêutica , Artéria Mesentérica Superior/diagnóstico por imagem , Polivinil/administração & dosagem , Tantálio/administração & dosagem , Ultrassonografia de Intervenção , Idoso , Aneurisma/diagnóstico por imagem , Humanos , Injeções , Masculino , Resultado do Tratamento
11.
Drug Deliv ; 27(1): 1378-1385, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32998587

RESUMO

Herein, electrospun zinc oxide nanoparticle/poly (vinylidene fluoride) (ZnONP/PVDF) composite fiber membranes were designed, fabricated, and tested for improved orthopedic applications. A single factor screening study was conducted to determine the optimal ZnONP/PVDF formulation based on osteoblast (bone forming cells) proliferation and antibacterial properties. Further, ZnONP/PVDF materials were characterized for their morphology, crystallinity, roughness, piezoelectric properties, and chemistry to understand such cell results. The optimal concentration of high molecular weight PVDF (18%, w/v) and a low concentration of ZnONPs (1 mg/ml) were identified for electrospinning at room temperature in order to inhibit bacterial colonization (without resorting to antibiotic use) and promote osteoblast proliferation. Compared to no ZnO/PVDF scaffold without Piezo-excited group,the study showed that on the 1 mg/ml ZnO/PVDF scaffolds with piezo-excitation, the density of SA and E.coli decreased by 68% and 56%.The density of osteoblasts doubled within three days(compared to the control). In summary, ZnONP/PVDF composite fiber membranes were formulated by electrospinning showing an exceptional ability to eliminate bacteria colonization while at the same time promote osteoblast functions and, thus, they should be further studied for a wide range of orthopedic applications.


Assuntos
Antibacterianos/administração & dosagem , Nanocompostos/administração & dosagem , Procedimentos Ortopédicos , Osteoblastos/efeitos dos fármacos , Polivinil/administração & dosagem , Óxido de Zinco/administração & dosagem , Antibacterianos/síntese química , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/fisiologia , Células Cultivadas , Humanos , Nanocompostos/química , Osteoblastos/fisiologia , Polivinil/síntese química , Alicerces Teciduais/química , Difração de Raios X/métodos , Óxido de Zinco/síntese química
12.
Drug Des Devel Ther ; 14: 2959-2975, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32801637

RESUMO

BACKGROUND AND PURPOSE: The traditional Chinese medicine, diosgenin (Dio), has attracted increasing attention because it possesses various therapeutic effects, including anti-tumor, anti-infective and anti-allergic properties. However, the commercial application of Dio is limited by its extremely low aqueous solubility and inferior bioavailability in vivo. Soluplus, a novel excipient, has great solubilization and capacity of crystallization inhibition. The purpose of this study was to prepare Soluplus-mediated Dio amorphous solid dispersions (ASDs) to improve its solubility, bioavailability and stability. METHODS: The crystallization inhibition studies were firstly carried out to select excipients using a solvent shift method. According to solubility and dissolution results, the preparation methods and the ratios of drug to excipient were further optimized. The interaction between Dio and Soluplus was characterized by differential scanning calorimetry (DSC), fourier transform infrared (FT-IR) spectroscopy, scanning electron microscopy (SEM), powder X-ray diffraction (PXRD) and molecular docking. The pharmacokinetic study was conducted to explore the potential of Dio ASDs for oral administration. Furthermore, the long-term stability of Dio ASDs was also investigated. RESULTS: Soluplus was preliminarily selected from various excipients because of its potential to improve solubility and stability. The optimized ASDs significantly improved the aqueous solubility of Dio due to its amorphization and the molecular interactions between Dio and Soluplus, as evidenced by dissolution test in vitro, DSC, FT-IR spectroscopy, SEM, PXRD and molecular docking technique. Furthermore, pharmacokinetic studies in rats revealed that the bioavailability of Dio from ASDs was improved about 5 times. In addition, Dio ASDs were stable when stored at 40°C and 75% humidity for 6 months. CONCLUSION: These results indicated that Dio ASDs, with its high solubility, high bioavailability and high stability, would open a promising way in pharmaceutical applications.


Assuntos
Diosgenina/farmacocinética , Desenvolvimento de Medicamentos , Medicamentos de Ervas Chinesas/farmacocinética , Excipientes/farmacocinética , Polietilenoglicóis/farmacocinética , Polivinil/farmacocinética , Administração Oral , Animais , Disponibilidade Biológica , Cromatografia Líquida de Alta Pressão , Cristalografia por Raios X , Diosgenina/administração & dosagem , Composição de Medicamentos , Estabilidade de Medicamentos , Medicamentos de Ervas Chinesas/administração & dosagem , Excipientes/administração & dosagem , Masculino , Medicina Tradicional Chinesa , Conformação Molecular , Simulação de Acoplamento Molecular , Polietilenoglicóis/administração & dosagem , Polivinil/administração & dosagem , Ratos , Ratos Sprague-Dawley , Solubilidade , Espectrometria de Massas em Tandem
14.
J Neurointerv Surg ; 12(12): 1214-1218, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32601261

RESUMO

BACKGROUND: Middle meningeal artery (MMA) embolization is an emerging therapy for the resolution of subacute or chronic subdural hematoma (CSDH). CSDH patients are often elderly and have several comorbidities. We evaluated our experience with transradial access (TRA) for MMA embolization using predominantly Onyx under conscious sedation. METHODS: Data for consecutive patients who underwent transradial MMA embolization for CSDH during a 2-year period (2018-2019) were analyzed from a single-center, prospectively-maintained database. Patient demographics, comorbidities, ambulatory times, subdural hematoma resorption status, and guide catheter type were recorded. Conversion to femoral access and complication rates were also recorded. Univariate and multivariate analyses were performed. RESULTS: Forty-six patients (mean age, 71.7±14.4 years) were included in this study. Mean CSDH size was 14±5.5 mm. Most (91.3%) TRA embolizations were performed with 6-French 0.071-inch Benchmark guide catheters (Penumbra). MMA embolization was successful in 44 patients (95.7%) (including two cases of TRA conversion). Twenty-one (48%) patients had a severe Charlson Comorbidity Index (>5). Symptomatic improvement was noted in 39 of 44 patients (88.6%). Mean length of stay was 4±3 days. Patients were ambulated immediately postprocedure. At mean follow-up (8±4 weeks), 86.4% of patients had complete or partial CSDH resolution. Persistent use of antiplatelet agents after the procedure was associated with failed or minimal CSDH resorption (5 of 6, 83.3% vs 9 of 38 23.7% with complete or near-complete resolution; P=0.009). CONCLUSION: Transradial Onyx MMA embolization under conscious sedation is safe and effective for CSDH treatment. TRA may be especially useful in elderly patients with numerous comorbidities.


Assuntos
Embolização Terapêutica/métodos , Hematoma Subdural Crônico/diagnóstico por imagem , Hematoma Subdural Crônico/terapia , Artérias Meníngeas/diagnóstico por imagem , Polivinil/administração & dosagem , Artéria Radial/diagnóstico por imagem , Tantálio/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste/administração & dosagem , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Vasc Health Risk Manag ; 16: 181-191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547045

RESUMO

OBJECTIVE: Treatment of brain arteriovenous malformations (AVMs) aims to abolish any risk for intracranial hemorrhage with the preservation of the patient's functional status. We present the technique of pre-surgical endovascular devascularization through proximal feeder artery occlusion for the treatment of cranial AVMs rather than nidus occlusion. Also, we highlight the advantages and the possible clinical indications. PATIENTS AND METHODS: Two patients with brain AVM and one patient with scalp AVM were treated by pre-surgical endovascular devascularization followed by surgical resection. Endovascular devascularization was performed by occlusion of the AVM feeders only with Liquid Embolic System Agent (Onyx®) 18 without entering and filling the nidus. During surgery, feeding arteries colored with the black color of the Liquid Embolic System Agent were clearly identified and cut. Dissection of the AVM was performed, and resection of the nidus was achieved. RESULTS: Total resection of the AVM was achieved in all cases confirmed with follow-up angiographies, with no neurologic or systemic complications. Also, no major bleeding was detected. In addition, the surgical clips were avoided during surgery. Brain AVMs were safely resected in piecemeal fashion. CONCLUSION: Pre-surgical endovascular proximal feeder artery devascularization technique shows to be a safe, simple and effective technique for the management of cranial arteriovenous malformations. This technique simplifies both the endovascular and surgical approaches to complicated cranial AVM cases.


Assuntos
Encéfalo/irrigação sanguínea , Embolização Terapêutica , Malformações Arteriovenosas Intracranianas/terapia , Polivinil/administração & dosagem , Couro Cabeludo/irrigação sanguínea , Tantálio/administração & dosagem , Procedimentos Cirúrgicos Vasculares , Adolescente , Adulto , Circulação Cerebrovascular , Pré-Escolar , Combinação de Medicamentos , Feminino , Humanos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/fisiopatologia , Masculino , Resultado do Tratamento
16.
J Neurointerv Surg ; 12(11): 1132-1136, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32434799

RESUMO

BACKGROUND: Precise delivery of liquid embolic agents (LEAs) remains a challenge in the endovascular treatment of dural arteriovenous fistulae (dAVFs) and cerebral arteriovenous malformations (cAVMs). Despite significant advances in the past decade, LEA reflux and catheter navigability remain shortcomings of current endovascular technology, particularly in small and tortuous arteries. The Scepter Mini dual-lumen balloon microcatheter aims to address these issues by decreasing the distal catheter profile (1.6 French) while allowing for a small (2.2 mm diameter) balloon at its tip. METHODS: We report our initial experience with the Scepter Mini in two patients with anterior cranial fossa dAVFs that were treated with transophthalmic artery embolization. RESULTS: In both patients, the Scepter Mini catheter was able to be safely advanced into the distal ophthalmic artery close to the fistula site, and several centimeters past the origins of the central retinal and posterior ciliary arteries. A single Onyx injection without any reflux resulted in angiographic cure of the dAVF in both cases, and neither patient suffered any vision loss. CONCLUSIONS: These initial experiences suggest that the Scepter Mini represents a significant advance in the endovascular treatment of dAVFs and cAVMs and will allow for safer and more efficacious delivery of LEAs into smaller and more distal arteries while diminishing the risk of LEA reflux.


Assuntos
Malformações Vasculares do Sistema Nervoso Central/diagnóstico por imagem , Malformações Vasculares do Sistema Nervoso Central/terapia , Embolização Terapêutica/métodos , Malformações Arteriovenosas Intracranianas/diagnóstico por imagem , Malformações Arteriovenosas Intracranianas/terapia , Artéria Oftálmica/diagnóstico por imagem , Adulto , Catéteres , Fossa Craniana Anterior/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polivinil/administração & dosagem , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/métodos
17.
J Vasc Interv Radiol ; 31(6): 986-992, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32414569

RESUMO

PURPOSE: To assess the feasibility, safety, and efficacy of balloon-assisted delivery of ethylene vinyl alcohol copolymer (EVOH) for a range of peripheral arterial applications. MATERIALS AND METHODS: Six academic medical centers entered retrospective data on 46 consecutive patients (27 men, 19 women; ages, 11-94 y; mean age, 50.3 y) who underwent 60 balloon-assisted EVOH procedures. The cohort was restricted to procedures involving peripheral, nonneural arteries 1-5.5 mm in diameter. Clinical indications included a wide range of vascular pathologic conditions (most commonly arteriovenous malformations [n = 20], renal angiomyolipomas [n = 8], and acute hemorrhage [n = 9]) and targeted visceral and musculoskeletal peripheral arteries. Data collected included sex, age, clinical indication, arterial pathology, arteries embolized, type of occlusion balloon microcatheter, type and concentration of EVOH agent, effectiveness as an embolic backstop, vessels protected, adequacy of EVOH cast penetration, catheter extraction, nontarget embolization, and complications. RESULTS: Balloon occlusion prevented EVOH reflux in 59 of 60 procedures (98.3%). Nontarget EVOH embolization occurred in 2 procedures (3.3%). Adequate EVOH cast penetration and complete filling of the target pathologic structure were seen in 57 of 60 procedures (95%). Balloon deflation and uneventful extraction occurred in all procedures; small EVOH fragments detached into target arteries in 2 cases. One major (1.7%) and 2 minor (3.3%) complications occurred. CONCLUSIONS: Balloon-assisted EVOH embolization of peripheral arteries is feasible, safe, effective, and versatile. The primary advantage of balloon-assisted EVOH embolization is the ability to apply more injection pressure to advance the EVOH cast assertively into the pathologic structure(s).


Assuntos
Malformações Arteriovenosas/terapia , Oclusão com Balão , Neoplasias/terapia , Polivinil/administração & dosagem , Doenças Vasculares/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Malformações Arteriovenosas/diagnóstico por imagem , Oclusão com Balão/efeitos adversos , Criança , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Polivinil/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Estados Unidos , Doenças Vasculares/diagnóstico por imagem , Adulto Jovem
18.
Biol Pharm Bull ; 43(7): 1052-1060, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32321879

RESUMO

Mesenchymal stem cells (MSCs) can effectively regulate immune cell functions and therefore are promising for the treatment of autoimmune disorders, such as immune thrombocytopenia (ITP). Recent research has shown that three-dimensional (3D) culture method have many advantages over conventional culture with respect to MSC secretion and immunogenicity. In this study, 2D and 3D cultured MSCs were used to evaluate cytokine secretion, extracellular matrix (ECM) gene expression, immune regulatory activity, and therapeutic effects in a mouse model of ITP. MSCs cultured on scaffolds had higher expression levels of immune regulatory genes, such as IDO1, HLA-G, and PTGS2, and greater inhibitory activity against lymphocyte activation that those of 2D-MSCs. In addition, 3D-MSCs exhibited higher ECM expression and greater protection against interferon-γ (IFN-γ)-induced apoptosis. In a mouse study, ITP was induced by guinea pig anti-mouse platelet serum injections. Based on enzyme-linked immunosorbent assays, serum levels of the suppressive cytokine interleukin (IL)-10 were higher and IFN-γ levels were lower after intravenous injection with 3D-MSCs and with 2D-MSCs. Additionally, 3D-MSCs improved the body weight, spleen index, and platelet index relative to those for 2D-MSCs. Bone marrow homing was also significantly enhanced in the 3D group. Therefore, the 3D culture of MSCs is an effective technique for the treatment of ITP.


Assuntos
Plaquetas/fisiologia , Técnicas de Cultura de Células/métodos , Células Endoteliais da Veia Umbilical Humana/fisiologia , Transplante de Células-Tronco Mesenquimais/métodos , Células-Tronco Mesenquimais/fisiologia , Púrpura Trombocitopênica Idiopática/terapia , Animais , Feminino , Cobaias , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Polivinil/administração & dosagem , Gravidez , Púrpura Trombocitopênica Idiopática/imunologia
19.
Pharm Dev Technol ; 25(7): 865-873, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32266855

RESUMO

Fenretinide (4-HPR), as a semi-synthetic retinoid, has apoptosis-promoting effects as a single agent and chemotherapy synergist in vitro. When a human ovarian cancer cells line (A2780s) was treated with both PTX and 4-HPR, there was a synergistic anti-cancer effect demonstrated with a average combination index of 0.44. In this research, a new TPGS-Soluplus® mixed micelles were developed which encapsulation efficiencies of paclitaxel (PTX) and fenretinide (4-HPR) were as high as 98%, and the average diameter of the micelles was 66.26 nm. Cytotoxicity of the mixed micelles co-delivered with PTX and 4-HPR reduced significantly 7.3 and 25.1 times compared with free drug respectively in A2780s cells. More importantly, in vivo pharmacokinetic study, the loaded drugs in mixed micelles exhibited higher AUC and t1/2 values than free drugs. Furthermore, in vivo antitumor efficacy experiments demonstrated that PF-TS exhibited superior in vivo antitumor activity on the inhibition rate of tumor growth than other treatment groups (77.8% corresponding tumor growth inhibition in PF-TS treated group vs 19.9, 12.5, and 26.0% of tumor growth inhibition rate in Taxol®, 4-HPR, and Taxol®+4-HPR, respectively). Therefore, the mixed micelles of co-deliver PTX and 4-HPR successfully constructed may hopefully be applied to the cancer combination treatment with less toxic effect and more antitumor activity.


Assuntos
Antineoplásicos/administração & dosagem , Sistemas de Liberação de Medicamentos/métodos , Fenretinida/administração & dosagem , Micelas , Paclitaxel/administração & dosagem , Polietilenoglicóis/administração & dosagem , Polivinil/administração & dosagem , Vitamina E/administração & dosagem , Animais , Antineoplásicos/farmacocinética , Linhagem Celular Tumoral , Portadores de Fármacos/administração & dosagem , Portadores de Fármacos/farmacocinética , Feminino , Fenretinida/farmacocinética , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Paclitaxel/farmacocinética , Polietilenoglicóis/farmacocinética , Polivinil/farmacocinética , Ratos , Ratos Wistar , Carga Tumoral/efeitos dos fármacos , Carga Tumoral/fisiologia , Vitamina E/farmacocinética , Ensaios Antitumorais Modelo de Xenoenxerto/métodos
20.
Drug Deliv ; 27(1): 565-574, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32252563

RESUMO

Hinokiflavone (HF) is a natural biflavonoid extracted from medicinal plants such as Selaginella tamariscina and Platycladus orientalis. HF plays a crucial role in the treatment of several cancers. However, its poor solubility, instability, and low bioavailability have limited its use. In this study, soluplus/d-α-tocopherol acid polyethylene glycol 1000 succinate (TPGS)/dequalinium (DQA) was applied to improve the solubilization efficiency and stability of HF. HF hybrid micelles were prepared via thin-film hydration method. The physicochemical properties of micelles, including particle size, zeta potential, encapsulation efficiency, drug loading, CMC value, and stability were investigated. The in vitro cytotoxicity assay showed that the cytotoxicity of the HF hybrid micelles was higher than that of free HF. In addition, the HF hybrid micelles improved anticancer efficacy and induced mitochondria-mediated apoptosis, which is associated with the high levels of ROS inducing decreased mitochondrial membrane potential, promoting apoptosis of tumor cells. Furthermore, in vivo tumor suppression, smaller tumor volume and increased expression of pro-apoptotic proteins were found in nude mice treated with HF hybrid micelles, suggesting that HF hybrid micelles had stronger tumor suppressive activity compared with free HF. In summary, HF hybrid micelles developed in this study enhanced antitumor effect, which may be a potential drug delivery system for the treatment of lung adenocarcinoma.


Assuntos
Adenocarcinoma de Pulmão/tratamento farmacológico , Antineoplásicos/administração & dosagem , Biflavonoides/administração & dosagem , Portadores de Fármacos/administração & dosagem , Neoplasias Pulmonares/tratamento farmacológico , Micelas , Mitocôndrias/efeitos dos fármacos , Células A549 , Animais , Antineoplásicos/farmacocinética , Antineoplásicos/farmacologia , Biflavonoides/farmacocinética , Biflavonoides/farmacologia , Dequalínio/administração & dosagem , Dequalínio/química , Dequalínio/farmacocinética , Portadores de Fármacos/química , Portadores de Fármacos/farmacocinética , Feminino , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Tamanho da Partícula , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/química , Polietilenoglicóis/farmacocinética , Polivinil/administração & dosagem , Polivinil/química , Polivinil/farmacocinética , Solubilidade , Ensaios Antitumorais Modelo de Xenoenxerto , alfa-Tocoferol/administração & dosagem , alfa-Tocoferol/análogos & derivados , alfa-Tocoferol/química , alfa-Tocoferol/farmacocinética
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