[Complication after selective arterial embolization in internal iliac artery and median sacral artery with gelfoam particle in dogs].

OBJECTIVE:To observe the complication after embolizing the bilateral internal iliac arteries and the median sacral artery of dogs by different combinations and embolization levels with gelfoam particle, and to provide a reference for safety application of gelfoam in clinic. METHODS:Sixteen common grade adult healthy dogs (weighing 10-13 kg, 14 males and 2 females) were randomly divided into 5 groups. Under the monitoring of digital subtraction angiography (DSA), the embolization was performed with gelfoam particle (diameter, 50-150 microm) in bilateral internal iliac arteries and the main branch of the median sacral artery (group A, n = 3), in bilateral internal iliac arteries and the first branch of the median sacral artery (group B, n = 3), in the main branch of bilateral internal iliac arteries (group C, n = 3), in the unilateral internal iliac artery and the main branch of the median sacral artery (group D, n = 4), and in the main branch of unilateral internal iliac artery (group E, n = 3). Under the DSA, the anatomic relationships of the abdominal aorta, bilateral external iliac arteries, bilateral internal iliac arteries, and median sacral artery were observed before embolization. The survival dogs were observed and the specimens of bladder, rectum, sciatic nerve, and gluteal muscles were harvested for the general and histological observations at 3 days after embolization. RESULTS:In dogs, there was no common iliac artery; bilateral external iliac arteries originated from the abdominal aorta and the starting of the median sacral artery had variation. Seven dogs (3 in group A, 3 in group C, and 1 in group D) died within 2 days after embolization, and the others survived to the end of the experiment. In the dead dogs of groups A, C, and D, the darkening and necrosis of the rectum were observed; the bladder presented lamellar obfuscation and focal hemorrhage and edema; and the median urinary volume in bladder was 270.6 mL. In survival dogs, no obvious change was observed in the rectum; the bladder only manifested light edema; and the median urinary volume in bladder was 137.0, 220.5, and 28.0 mL, respectively in groups B, D, and E. The rectum and bladder of dead dogs in groups A, C, and D manifested the disrupted cells, generous inflammatory cells infiltration, and desquamation of epithelial cells; the rectum and bladder of survival dogs in groups B, D, and E manifested light inflammatory cells infiltration and edema; the embolized artery mainly focused on the arterioles whose diameter was 100-200 microm. The sciatic nerve and gluteal muscles of each group had no obvious change except for light edema. CONCLUSION:When the internal iliac artery and median sacral artery are embolized with gelfoam particle with a diameter of 50-150 microm, to ensure the safeness of pelvic organs, the embolized artery can not exceed the first branch when the 3 arteries are embolized at the same time, or reserve at least unilateral internal iliac artery when embolized to the trunk, or it will result in pelvic organ necrosis and perforation.