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Thesis

French

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10670/1.wy2k3k

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A Synthesis of Papers on Embolization

Abstract

Embolization is an increasing part of the activity of endovascular interventional radiology. Embolization agents are numerous, have variable properties and make it possible to obtain a hemostasis, a hemodiversion, or achieve the vector of a targeted therapy. Our work is divided into three parts, successively aimed at a state of the art of available embolization agents, then original laboratory work, and finally the retrospective analysis of various radio-clinical studies made in our research center. The first part based on an analysis of the literature constitutes an introductory chapter in which the technical characteristics, the advantages and the limits of the embolization agents used in current clinical practice are assessed. The second part is based on fundamental animal studies carried out in the experimental catheterization laboratory of ISIT (Professors Boyer and Lusson) at the Faculty of Medicine of Clermont-Ferrand, and in the laboratory of endovascular biomaterials of the university. of Montreal (Professor Lerouge and Soulez). In a first series of experiments, in Montreal, we participated in the development of an embolization agent that combines the advantages of a gel (solidification in contact with blood) and a sclerosant (destruction of endothelial cells). The gel thus developed has been the subject of a patent application. It may be able to prevent and / or treat the leaks observed in stent-graft treatment of aortic aneurysms. In a second experimental protocol, in Clermont-Ferrand, we analyzed the interaction between embolization agent and chemotherapy by studying the pharmacokinetic changes observed according to the route of administration and the association with partial or complete embolization of the hepatic artery on a porcine model. The third part is based on original clinical work analyzing retrospectively various sensitive points in parenchymal embolization. This part is based on strong multidisciplinary collaborations in gynecological, urological, hepatic and splenic pathologies. Finally, it is necessary to announce the publication scheduled for the first quarter of 2012 of the book "Embolisation" (350 pages, Springer Ed., P. Chabrot and L. Boyer). An English version of this book will follow in the course of 2012.

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