Innovation in catheter design for intra-arterial liver cancer treatments results in favorable particle-fluid dynamics

Background: liver tumors are increasingly treated with radioembolization. here,we present first evidence of catheter design effect on particle-fluid dynamics and downstream branch targeting during microsphere administrations. materials and methods: a total of 7 experiments were performed in a bench-top model of the hepatic arterial vasculature with recreated hemodynamics. fluorescent microspheres and clinically used holmium microspheres were administered with a standard microcatheter (smc) and an anti-reflux catheter (arc) positioned at the same level along the longitudinal vessel axis. catheter-related particle flow dynamics were analyzed by reviewing video recordings of uv-light illuminated fluorescent microsphere administrations. downstream branch distribution was analyzed by quantification of collected microspheres in separate filters for two first-order branches. mean deviation from a perfectly homogenous distribution (dhd) was used to compare the distribution homogeneity between catheter types. results: the smc administrations demonstrated a random off-centered catheter position (in 71 % of experiments),and a laminar particle flow pattern with an inhomogeneous downstream branch distribution,dependent on catheter position and injection force. the arc administrations demonstrated a fixed centro-luminal catheter position,and a turbulent particle flow pattern with a more consistent and homogenous downstream branch distribution. quantitative analyses confirmed a significantly more homogeneous distribution with the arc; the mean dhd was 40.85 % (iqr 22.76 %) for the smc and 15.54 % (iqr 6.46 %) for the arc (p = 0.047). conclusion: catheter type has a significant impact on microsphere administrations in an in-vitro hepatic arterial model. a within-patient randomized controlled trial has been initiated to investigate clinical catheter-related effects during radioembolization treatment. © 2015 van den hoven et al.