Pressure-Enabled Drug Delivery Significantly Increases Intra-Arterial Delivery of Embolic Microspheres to Liver Tumors in a Porcine Model

Abstract

This study aimed to test the hypothesis that pressure-enabled drug delivery (PEDD) with a pressure-modulating microcatheter device (TriNav; TriSalus Life Sciences, Westminster, Colorado) would increase delivery of microspheres via hepatic arterial infusion to liver tumors in an Oncopig model (Sus Clinicals, Chicago, Illinois) when compared with a conventional end-hole microcatheter. Trisacryl gelatin microspheres (100–300 μm in size) were fluorescently labeled and infused into porcine liver tumors using conventional technique (n = 8) or by PEDD (n = 8). Liver tissue was harvested, and images were analyzed with a custom deep learning algorithm (Visiopharm, Hørsholm, Denmark) to quantitate signal intensity. PEDD increased microsphere penetration into the tumor by 227% (P = .029) when compared with conventional methodology and improved the tumor–to–normal tissue ratio from 2.7 to 4.2. These data demonstrate improved delivery into tumor tissue using PEDD, along with improved selectivity by minimizing relative off-target deposition.