《hepasphere栓塞微球临床应用与病例分享_临床医学_医药》由会员分享，可在线阅读，更多相关《hepasphere栓塞微球临床应用与病例分享_临床医学_医药（45页珍藏版）》请在金锄头文库上搜索。
1、HepaSphere栓塞微球临床应用及病例分享,1990 : 由日本教授Hori发明，名称：SAP* 1992 : 首次应用于临床 2000 : 应用于HCC的初步研究 2004 : 获得欧盟认证，名称：HepaSphere 2006 : 获得美国认证，名称：QuadraSphere,历史,*SAP：Superabsorbent Polymer Microsphere,HepaSphere的材质,乙酸乙烯和丙烯酸甲酯经聚合皂化反应生成的共聚物聚丙烯酸钠乙烯醇(poly vinylalcohol-co-acrylic acid),HepaSphere栓塞微球 干态包装，每瓶25mg 500-10
2、0um粒径，139,000微粒/瓶 30-60um粒径，815,000微粒/瓶,HepaSphere的粒径,小粒径微球才更有可能实现末梢栓塞，效果才会更好,可压缩直径的80%,良好的弹性，撤掉外力即可恢复原来的形状 可变形，能复原像棉花糖一样,HepaSphere的物理性能,TACE 精准的靶向性（Targeted） 良好的吸收性（Absorbing） 高度的随形性（Conforming） 真正的载药性（Eluting）,HepaSphere的特性,HepaSphere微球粒径分布均一 50-100um粒径HepaSphere微球，95%在40-110um区间内 粒径均匀，更易完成指定层面栓塞
3、,Guido Poggi et al. Transhepatic arterial chemoembolization with oxaliplatin-eluting microspheres (OEM-TACE) for unresectable hepatic tumors, Anticancer Res. 2008 Nov-Dec;28(6B):3835-42,精准的靶向性（Targeted）,HepaSphere不会在血管近端或者远端发生聚集 在体内栓塞的血管直径与其粒径大小一致,Khankan AA, Osuga K, Hori S et al.Embolic effects of
4、 superabsorbent polymer microspheres in rabbit renal model: comparison with tris-acryl gelatin microspheres and polyvinyl alcohol. Radiat Med 22:384390 Bilbao Jl, De Luis E, Garcia De Jalon JA et al. Comparative study of four different spherical embolic particles in an animal model: a morphologic an
5、d histologic evaluation. J Vasc Interv Radiol. 2008 Nov;19(11):1625-38,精准的靶向性（Targeted）,注射前需要水合 水合时产品能较好吸收水基溶液，吸收部分药液 吸收后以球形方式膨胀，直径为原来的2-4倍,良好的吸收性（Absorbing）,良好的吸收性（Absorbing）,Hepa膨胀的大小受控于水基溶液的离子浓度,HepaSphere可以像血管腔的模子一样堵在血管腔内，形成完全的栓塞 HepaSphere与血管腔高度随形，在血管内不断裂，也不移位，平均每个血管腔内一个颗粒 HepaSphere很软，容易压缩，所以能
6、够适合管腔的形状并实现完全堵塞,Khankan AA, Osuga K, Hori S et al.Embolic effects of superabsorbent polymer microspheres in rabbit renal model: comparison with tris-acryl gelatin microspheres and polyvinyl alcohol. Radiat Med 22:384390 Bilbao Jl, De Luis E, Garcia De Jalon JA et al. Comparative study of four differ
7、ent spherical embolic particles in an animal model: a morphologic and histologic evaluation. J Vasc Interv Radiol. 2008 Nov;19(11):1625-38,高度的随形性（Conforming）,在人体组织上得到的证实：与血管内皮紧密接触并随形，从而达到完全性栓塞的效果,Klass et al 2014. ANTICANCER RESEARCH 34: 3597-3606 (2014),高度的随形性（Conforming）,Bilbao et al. “Comparative
8、 Study of Four Different Spherical Embolic Particles in an Animal Model: A Morphologic and Histologic Evaluation.” J Vasc Interv Radiol 2008; 19(11): 1625-38.,载药微球与肿瘤血管内皮接触越紧密，抗癌药物缓释到肿瘤内部的效果越好,Photos courtesy of Keigo Osuga,高度的随形性（Conforming）,机械吸收 HepaSphere由干燥的颗粒变成水合微球 约在10分钟内完成 正负电荷结合 HepaSphere微球
9、带负电荷的丙烯酸酯与带正电荷的盐酸多柔比星之间形成离子键1,Kos S et al., Elution characteristics of doxorubicin-loaded microspheres differ by drug-loading method and microsphere size, J Vasc Interv Radiol. 2011 Mar;22(3):361-8,真正的载药性（Eluting）,HepaSphere为整体载药1，2,Sebastian Kos et al. Elution Characteristics of Doxorubicin-loaded
10、Microspheres Differ by Drug-loading Method and Microsphere Size, J vasc Interv radiol 2011; 22: 361-368 David M. Liu et al. Optimization of Doxorubicin Loading for Superabsorbent Polymer Microspheres: in vitro Analysis, Cardiovasc Intervent Radiol (2012) 35: 391-398,真正的载药性（Eluting）,HepaSphere可加载多种药物
11、： 多柔比星1 顺铂2,3,4 伊立替康5 奥沙利铂6,Kos S et al. Elution characteristics of doxorubicin-loaded microspheres differ by drug-loading method and microsphere size, J Vasc Interv Radiol. 2011 Mar;22(3):361-8 Maeda N et al., In vivo evaluation of cisplatin-loaded superabsorbent polymer microspheres for use in che
12、moembolization of VX2 liver tumors, J Vasc Interv Radiol. 2012 Mar;23:397-404 Maeda N et al., In vitro characterization of cisplatin-loaded superabsorbent polymer microspheres designed for chemoembolization, J Vasc Interv Radiol. 2010;21(6):87781 Huppert P, Transcatheter Arterial Chemoembolization (
13、TACE) of Colorectal Cancer Liver Metastases by Irinotecan-Eluting Microspheres in a Salvage Patient Population, Cardiovasc Intervent Radiol. 2013 May; 37(1): 154-164 Poggi G, Transhepatic arterial chemoembolization with oxaliplatin-eluting microspheres (OEM-TACE) for unresectable hepatic tumors, Ant
14、icancer Res. 2008 Nov-Dec;28(6B):3835-42 Poggi G, Oxaliplatin-eluting microspheres for the treatment of intrahepatic cholangiocarcinoma: a case report, Anticancer Res . 2008 Sep-Oct;28(5B):2987-90,真正的载药性（Eluting）,HepaSphere的载药时间,Merit brochure,50-100m HepaSphere: 15 分钟加载95%以上的多柔比星 按照麦瑞通推荐的载药方法可以达到这种
15、载药效果,Kos S et al. Elution characteristics of doxorubicin-loaded microspheres differ by drug-loading method and microsphere size, J Vasc Interv Radiol. 2011 Mar;22(3):361-8,HepaSphere的载药时间,3组VX2兔模型，分别为HepaSphere加载阿霉素，碘油+阿霉素+Embo栓塞的 cTACE，以及经肝动脉灌注阿霉素（HAI） Hepa组14天后局部药物浓度仍可以达到治疗效果,Gupta et al. “Hepatic
16、 Arterial Embolization with Doxorubicin-Loaded Superabsorbent Polymer Microspheres in a Rabbit Liver Tumor Model.” Cardiovasc Intervent Radiol 2011; 34(5):1021-30,Hepa组：14天肿瘤内部药物浓度大于50ng/mg cTACE组：第3天已经接近为0,HepaSphere的药代动力学特性,HepaSphere的药代动力学特性,HepaSphere能够有效加载多柔比星 HepaSphere做到了持续释放，在各时间点均可提高肿瘤内多柔比星的浓度,Lee et al. “Doxorubicin-Loaded QuadraSphere Microspheres: Plasma Pharmacokinetics and Intratumoral Drug Concentration in an Animal Model of Liver Cancer.” Cardiovasc Intervent Radiol
