Article Figures & Data
Figures
- Fig 1.
Characteristics of PIB. A, PIB is a flowable solution at low temperature, and (B) becomes a solid white gel at high temperature (≥36°C). C, PIB is injected into 37°C water through a 2.7F microcatheter and rapidly solidifies as a white gel.
- Fig 2.
Contact radiographs of the kidneys embolized by PIB at various injection rates. A, PIB with low injection rate (0.05 mL/s) reaches the proximate segmental and interlobar arteries. B, With increasing of injection rate (0.10 mL/s), distribution becomes wider. C, PIB with high injection rate (0.15 mL/s) penetrates the peripheral vessels.
- Fig 3.
Microscopic views of the kidneys embolized by PIB (arrows in the figures) at various injection rates. A, PIB with low injection rate (0.05 mL/s) only reaches the interlobar artery, and (B) that with 0.10 mL/s locates in the interlobular and arciform arteries (the empty spaces in the embolized lumen are due to dissolution of the copolymer during processing and staining of the histologic specimen at room temperature) (EVG stain, ×100). C, PIB with 0.15 mL/s within glomerular capillaries (hematoxylin-eosin stain, ×200). Neither vascular injury nor hemorrhagic change is observed.
- Fig 4.
Selective right renal arterial angiograms. A, Angiogram obtained 10 minutes after embolization with PIB shows complete occlusion of the right main renal artery (large arrowhead). B, Three months after embolization, the right main renal artery (large arrowhead) remains totally occluded and the affected kidney (small arrowheads) shows marked shrinkage.
- Fig 5.
Gross outside and section views of the embolized and control kidney at 3 months after embolization with PIB showing notable atrophy (A), and calcification (B) of the affected kidney compared with the left untreated kidney.
- Fig 6.
Microscopic views of the embolized kidneys at 1 week (A), 1 month (B, C), 2 months (D, E) and 3 months (F) after the injection of PIB (arrows in the figures). A, The occluding plug consists almost exclusively of PIB, with mild inflammatory reaction (hematoxylin-eosin stain, ×200). B, Atrophic glomeruli (curved arrows) are surrounded by sclerotic tissues. Intraluminal PIB and vessel walls are not infiltrated and no foreign body reaction is observed (hematoxylin-eosin stain, ×200). C, A mixture of PIB and fibrous tissue (asterisk), with mild inflammatory response, is present in the lumen and the IEL is unaffected (EVG stain, ×400). D, PIB is surrounded by fibrous tissue (asterisk) in the lumen without signs of neovascularization or mural hemorrhage (hematoxylin-eosin stain, ×400). E, The vessel lumen is filled with PIB and fibrous tissue (asterisk), accompanied with few cellular infiltrations, and the arterial wall remains intact (EVG stain, ×400). F, PIB remains inside the vessel without extravasation or cellular infiltration. The necrotic, fibrotic, and calcific kidney tissues are seen throughout in the view (hematoxylin-eosin stain, ×100).
Tables
Injection Rate (mL/s) Embolized Renal Artery Level 0.05 Segmental and interlobar arteries 0.10 Arcuate and interlobular arteries 0.15 Interlobular arteries, afferent arterioles, and glomerular capillaries Follow-Up Intraluminal Inflammation Perivascular Inflammation Vascular Injury Mural Hemorrhage Extravasation Neovascularization 1 week Mild Mild None Absent Absent Absent 1 month None or mild Mild None Absent Absent Absent 2 months None or mild None or mild None Absent Absent Absent 3 months None None None Absent Absent Absent
