A Reexamination of the Angiotoxicity of Superselective Injection of DMSO in the Swine Rete Embolization Model
,
John C. Chaloupka,a,
Daniel C. Huddlea,
Jonathan Aldermana,
Stanley Finka,
Robert Hammonda and
Harry V. Vintersa
a From the Departments of Diagnostic Radiology (J.C.C., D.C.H., J.A.) and Neurosurgery (J.C.C.), Yale University School of Medicine; Clinical Research Consultant, MicroTherapeutics, Inc, San Clemente, CA (S.F.); the Department of Pathology, London Health Sciences Centre (R.H.); and the Department of Pathology, UCLA School of Medicine (H.V.V.).
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FIG 1. Angiographic demonstration of vasospasm associated with DMSO infusion.
A, DSA from superselective left ascending pharyngeal artery injection (anteroposterior projection) shows normal filling of the ascending pharyngeal and retial system.
B, Repeat DSA from selective left CCA injection 3 minutes after infusion of 0.8 mL DMSO over 90 seconds shows grade 3 vasospasm affecting the ascending pharyngeal artery (arrow).
C, Repeat DSA from left CCA injection 12 minutes after DMSO infusion shows complete resolution of vasospasm.
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FIG 2. Nonspecific microscopic histopathologic changes in both control and exposed retia.
A, Control rete: extensive separation and sloughing of otherwise normal-appearing endothelial cells (short arrows) are seen within multiple microarteries, most likely the result of preparation artifacts. There is also mild periadventitial inflammation (long arrows) (hematoxylin-eosin, original magnification x100).
B, Control rete: endoluminal refractile bodies (short arrows) are seen in association with granulomatous inflammation and foreign body giant cells (long arrow) (hematoxylin-eosin, original magnification x150).
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FIG 3. Microscopic histopathologic changes in exposed retia possibly attributable to DMSO angiotoxicity.
A, Exposed rete (0.8 mL per 30 seconds): single microartery shows extensive transmural chronic inflammation and angionecrosis (hematoxylin-eosin, original magnification x150).
B, Exposed rete (0.8 mL per 60 seconds): single microartery is completely occluded with amorphous foreign material and has focal transmural chronic inflammation (arrows) (hematoxylin-eosin, original magnification x150).
C, Exposed rete (0.8 mL per 90 seconds): single microartery shows only moderate intimal hyperplasia (hematoxylin-eosin, original magnification x150).
D, Exposed rete (0.8 mL per 60 seconds): single microartery shows evidence of focal angionecrosis and endoluminal granulomatous inflammation with foreign body giant cell formation (arrow) (hematoxylin-eosin, original magnification x150).
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