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Session: Vascular - II
Session starts: Friday 27 January, 11:30
Presentation starts: 11:30
Room: Room 559

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Tess Snoeijink ()
Jan van der Hoek ()
Hadi Mirgolbabaee ()
Frank Nijsen ()
Erik Groot Jebbink ()

Abstract:
Introduction: Transarterial radioembolization (TARE) has become an established treatment method for primary and secondary liver cancer [1]. TARE consists of a catheter-based intraarterial infusion of radioactive microspheres. The microspheres are transported through the arterial liver vasculature until they lodge predominantly in and around the tumour to deliver a high local radiation dose [2]. Even though TARE has been used in clinical practice for over 20 years, the exact mechanisms behind the distribution remain unknown. Recent in silico studies point towards a major influence of axial catheter location on the distribution of microspheres [3-5]; however, it often lacks validation. The aim of the current study was to investigate the influence of axial catheter location and movement on the microsphere distribution in an idealized in vitro model. Method: An idealized, 2D, symmetrical, right hepatic artery phantom was developed which bifurcates three times into eight outlets. Hemodynamics were recreated using a programmable piston pump (SuperPump, ViVitro labs, Victoria, Canada). In total, 30 injections with non-irradiated holmium loaded poly(L-lactic acid) microspheres (Quirem Medical B.V., Deventer, The Netherlands) were performed with two types of catheters (Progreat 2.7F microcatheter and a rigid counterpart) at 0, 1.5 and 3.0 cm upstream of the first bifurcation. The outflow distribution was analysed by collecting the injected microspheres at each outlet and counting particle volumes using a Coulter Counter Multisizer 3 (Beckman Coulter Nederland, Mijdrecht, the Netherlands). Motion analysis over time and initial positioning of the catheter was performed using two cameras (top and side view, Logitech BRIO webcam, Logitech). Results: A larger longitudinal distance from the bifurcation led to a more homogeneous microsphere distribution among the outlets. For the clinical catheter, maximal deflections of 0.8 mm (top view) and 0.6 mm (side view) through the vessel lumen were observed, while the rigid catheter showed no movement. Conclusion: The current work confirms the influence of longitudinal catheter location on the distribution of microspheres. Moreover, movement of the clinical catheter through the lumen influenced the downstream distribution of microspheres, which should be further investigated. Future research should focus on whether the observed movement of the catheter also occurs in clinical practice. References: [1] P Hilgard et al., Hepatology 52 (5), 1741 (2010). [2] MTM Reinders et al., Seminars in Nuclear Medicine 49 (3), 237 (2019). [3] T Bomberna et al., Expert Opin Drug Deliv 18 (3), 409 (2021). [4] J Aramburu et al., J Biomech 49 (15), 3705 (2016). [5] A Taebi et al., J Biomech Eng 143 (1), 01 (2021).