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

## TL;DR

A new catheter design improves the even distribution of treatment particles during liver cancer therapy, compared to standard catheters.

## Contribution

First evidence showing catheter design impacts particle-fluid dynamics and treatment distribution in liver cancer radioembolization.

## Key findings

- Standard catheters caused inhomogeneous particle distribution due to off-centered positioning and laminar flow.
- Anti-reflux catheters provided more consistent and homogeneous distribution with turbulent flow and central positioning.
- Quantitative analysis showed significantly lower deviation in distribution with the anti-reflux catheter.

## Abstract

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.

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.

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).

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.

The online version of this article (doi:10.1186/s13046-015-0188-8) contains supplementary material, which is available to authorized users.