Review of the development of methods for characterization of microspheres for use in embolotherapy: translating Bench to Cathlab

Abstract

Therapeutic embolotherapy is the deliberate occlusion of a blood vessel within the body, which can be for the prevention of internal bleeding, stemming of flow through an arteriovenous malformation, or occlusion of blood vessels feeding a tumour. This is achieved using a wide selection of embolic devices such as; balloons, coils, gels, glues and particles.

Particulate embolization is often favoured for blocking smaller vessels, particularly within hyper-vascularised tumours, as they are available in calibrated sizes and can be delivered distally via microcatheters for precise occlusion with associated locoregional drug delivery.

Embolic performance has been traditionally evaluated using animal models, but with increasing interest in the 3R’s (Replacement, Reduction, Refinement), manufacturers, regulators and clinicians have shown interest in the development of more sophisticated in vitro methods for evaluation and prediction of in vivo performance. Herein we review the current progress in developing bespoke techniques incorporating; physical handling, fluid dynamics, occlusive behaviour and sustained drug elution kinetics within vascular systems.

Whilst it is necessary to continue to validate the safety of such devices in vivo, great strides have been made in the development of bench tests that better predict the behaviour of these products aligned with the principles of the 3R’s.

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Identifiers

ORCID for Xunli Zhang: orcid.org/0000-0002-4375-1571

ORCID for Martyn Hill: orcid.org/0000-0001-6448-9448

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