Development of a Novel Endovascular Brachytherapy Stent: A Proof-of-concept Study

Background and Aims: Endovascular implantation of io-dine-125 (I-125) seeds strand combined with stent is an effec-tive method of treatment for portal vein tumor thrombosis. The aim of this study was to develop a novel endovascular brachytherapy stent (EVB-Stent) and to evaluate its feasi-bility of use. Methods: An EVB-Stent was implanted into the main portal vein (MPV) in a live porcine model via the percutaneous transhepatic route. Blood samples were col-lected and tested before and after operation, as well as before euthanasia. Single-photon emission computed to-mography (SPECT) combined with CT (SPECT/CT) scan were performed directly after operation and CT scan was performed 2 months after implantation. After the CT scan was performed, all animals were euthanized and histologi-cally examined. Results: The novel stent was successfully positioned in all six pigs. No deterioration of liver function was observed during the 2-month follow-up period. SPECT/ CT revealed the uniform distribution of radiation around the seeds strand, and the hottest spot was near the center of the MPV. The patency of the stented MPV was confirmed using CT scans. The tissue-accumulated absorbed dose was 31,822.11 mGy at 10 mm transversely away from the mid-point of the I-125 seeds strand, with a half-life of 59.4 days. Pathological examination results showed no significant at-rophy or inflammation of adjunct liver tissue, and no obvi-ous intima thickening or thrombosis were detected in the stented MPV. Conclusions: A liver porcine model was used to demonstrate that the transhepatic placement of a novel endovascular brachytherapy stent, EVB-Stent, is both tech-nically feasible and safe.