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经导管动脉栓塞术（Transcatheter arterial embolization,TAE）作为一种微创介入治疗手段，具有创伤轻微、恢复迅速等显著优势，被广泛应用于多种血管性疾病的治疗。栓塞剂是TAE手术的核心材料，其性能直接影响手术效果与术后预后。传统栓塞剂主要分为固体栓塞剂与液体栓塞剂两大类，其中液体栓塞剂已从早期传统非黏附性液体栓塞剂逐步发展为具有环境响应固化、优异病灶适配性、低生物毒性以及影像示踪与载药协同等多功能集成特性的新型智能栓塞剂。本文综述了各类栓塞剂的栓塞机制、技术特点及临床应用现状，分析其优势与局限；重点探讨了新型智能栓塞剂在材料设计、性能优化及多功能集成方面的最新进展；同时阐述了影像示踪、药物控释以及3D打印、远程调控等新兴技术在提升栓塞手术安全性与疗效中的关键作用，旨在为未来智能、多功能栓塞剂的研发与临床转化提供有益参考。
Abstract：Transcatheter arterial embolization(TAE), as a minimally invasive interventional therapy, has the advantages of mild trauma and rapid recovery, and is widely used in the treatment of a variety of vascular diseases. Embolic agent is the core material of TAE, and its performance directly affects the surgical effect and postoperative prognosis. Traditional embolic agents are mainly divided into two categories: solid embolic agents and liquid embolic agents. Among them, the liquid embolic agent has gradually developed from the early traditional non adhesive liquid embolic agent to a novel intelligent embolic agent featuring multifunctional integrated characteristics, including environment-responsive solidification, excellent lesion adaptability, low biotoxicity, as well as imaging tracking and drug-loading synergies. This paper systematically reviewed the embolic mechanism, technical characteristics and clinical application status of various embolic agents, and analyzed their advantages and limitations; The latest progress of the new intelligent embolic agent in material design, performance optimization and multi-functional integration was discussed; At the same time, the key roles of emerging technologies such as image tracing, drug controlled release, 3D printing, and remote control in improving the safety and efficacy of embolization surgery were elaborated, aiming to provide a useful reference for the development and clinical transformation of intelligent and multifunctional embolic agents in the future.
[1]Schroeder G,Edalati M,Tom G,et al. Assessing the aneurysm occlusion efficacy of a shear-thinning biomaterial in a 3D-printed model[J]. J Mech Behav Biomed Mater,2022,130:105156.
[2]Zehtabi F,Gangrade A,Tseng K,et al. Injectable shearthinning hydrogels with sclerosing and matrix metalloproteinase modulatory properties for the treatment of vascular malformations[J]. Adv Funct Mater,2023,33(51):2305880.
[3]Zhao K,Varghese P J G,Chen P,et al. Developing a transcatheter injectable nanoclay-alginate gel for minimally invasive procedures[J]. J Mech Behav Biomed Mater,2024,152:106448.
[4]Baidya A ,Haghniaz R ,Tom G ,et al. A cohesive shear-thinning biomaterial for catheter-based minimally invasive therapeutics[J]. ACS Appl Mater Interfaces,2022,14(38):42852-42863.
[5]Liu Y,Peng X,Qian K,et al. Temperature sensitive p(N-isopropylacrylamide-co-acrylic acid)modified gold nanoparticles for trans-arterial embolization and angiography[J]. J Mater Chem B,2017,5(5):907-916.
[6]Chang C T,Chen H T,Girsang S P,et al. 3D-printed radiopaque polymer composites for the in situ monitoring of biodegradable medical implants[J]. Appl Mater Today,2020,20:100771.
[7]Kunkel R,Laurence D,Wang J,et al. Synthesis and characterization of bio-compatible shape memory polymers with potential applications to endovascular embolization of intracranial aneurysms[J]. J Mech Behav Biomed Mater,2018,88:422-430.
[8]Wong Y S,Salvekar A V,Zhuang K D,et al. Bioabsorbable radiopaque water-responsive shape memory embolization plug for temporary vascular occlusion[J]. Biomaterials,2016,102:98-106.
[9]Mühl-Benninghaus R,Fries F,Kie?ling M,et al. Vascular response on a novel fibrin-based coated flow diverter[J].Cardiovasc Intervent Radiol,2022,45(2):236-243.
[10]Chopra A M,Mehta M,Bismuth J,et al. Polymer coating embolism from intravascular medical devices-a clinical literature review[J]. Cardiovasc Pathol,2017,30:45-54.
[11]Grüter B E,Canzanella G,H?gler J,et al. Topographic distribution of inflammation factors in a healing aneurysm[J]. J Neuroinflammation,2023,20(1):182.
[12]Wu Z,Zhang M,Tian R,et al. Clinical efficacy of TACE using coil or gelatin sponge combined with targeted therapy in the treatment of giant hepatocellular carcinoma with arterioportal fistulas[J]. BMC Gastroenterol,2025,25(1):387.
[13]Ahnfelt E,Sj?gren E,Hansson P,et al. In vitro release mechanisms of doxorubicin from a clinical bead drugdelivery system[J]. J Pharm Sci,2016,105(11):3387-3398.
[14]Tian L,Lu L,Feng J,et al. Radiopaque nano and polymeric materials for atherosclerosis imaging,embolization and other catheterization procedures[J]. Acta Pharm Sin B,2018,8(3):360-370.
[15]Yu Z,He Y,Wang M,et al. Enhanced magnetic thermal ablation combined with immunotherapy for hepatocellular carcinoma using engineering microspheres[J]. Mater Today Bio,2025,35:102597.
[16]Weng J,Wu S,Pan Y,et al. pH-sensitive adriamycin hydrochloride and oxaliplatin dual-loaded microspheres synergistically enhance local injections effect of hepatocellular carcinoma[J]. Mater Today Bio,2024,29:101311.
[17]Li J ,Xu J ,Wang Y ,et al. Fusible and radiopaque microspheres for embolization[J]. Adv Mater,2024,36(39):e2405224.
[18]Si-Mohamed S A ,Cierco A ,Gamondes D ,et al.Embolization of recurrent pulmonary arteriovenous malformations by ethylene vinyl alcohol copolymer(onyx?)in hereditary hemorrhagic telangiectasia:safety and efficacy[J]. J Pers Med,2022,12(7):1091.
[19]Patidar Y ,Srinivasan S V ,Singh J ,et al. Clinical outcomes of transcatheter arterial embolization using Nbutyl-2-cyanoacrylate(NBCA)in cirrhotic patients[J]. J Clin Exp Hepatol,2022,12(2):353-361.
[20]Pal A,Zdrale G,Loui M,et al. Development of dualcrosslinking N-isopropylacrylamide-based injectable hydrogel for transcatheter embolization in swine model[J]. Gels,2025,11(3):156.
[21]Lu D,Wang J,Li Y,et al. Tumor noninvasive and target embolization therapy platform by intravenous injection based on acidic microenvironment-responsive hyperbranched poly(amino acid)s[J]. ACS Cent Sci,2020,6(11):1977-1986.
[22]Lym J S,Nguyen Q V,Ahn D A W,et al. Sulfamethazinebased pH-sensitive hydrogels with potential application for transcatheter arterial chemoembolization therapy[J].Acta Biomater,2016,41:253-263.
[23]Xie R,Chen Y C,Zhao Y,et al. Injectable hydrogel capable of in situ covalent crosslinking for permanent embolization[J]. ACS Appl Mater Interfaces,2021,13(48):56988-56999.
[24]Zhou X,Li Y,Chen S,et al. Dynamic agent of an injectable and self-healing drug-loaded hydrogel for embolization therapy[J]. Colloids Surf B Biointerfaces,2018,172:601-607.
[25]Zhang K,Han S,Lee Y,et al. Gigantic current control of coercive field and magnetic memory based on nanometerthin ferromagnetic van der Waals Fe3 GeTe2[J]. Adv Mater,2021,33(4):e2004110.
[26]Poupart O ,Schmocker A ,Conti R ,et al. In vitro implementation of photopolymerizable hydrogels as a potential treatment of intracranial aneurysms[J]. Front Bioeng Biotechnol,2020,8:261.
[27]de Bruijn A M,Smink M,Lohle P N M,et al. Uterine artery embolization for the treatment of adenomyosis:a systematic review and meta-analysis[J]. J Vasc Interv Radiol,2017,28(12):1629-1642. e1.
[28]Wang X,Yang H,Wang Y,et al. An injectable and dual-crosslinked hydrogel for controlled and permanent vascular embolization[J]. Bioact Mater,2025,53:141-160.
[29]Yun Q,Li L,Hu Z,et al. Layered transition metal dichalcogenide-based nanomaterials for electrochemical energy storage[J]. Adv Mater,2020,32(1):e1903826.
[30]Fan L,Duan M,Xie Z,et al. Injectable and radiopaque liquid metal/calcium alginate hydrogels for endovascular embolization and tumor embolotherapy[J]. Small,2020,16(2):e1903421.
[31]Zhao K,Chen P,Wang Z,et al. A multi-modal embolic gel system for long-term fluorescence imaging and photothermal therapy[J]. Biomater Adv,2025,174:214298.
[32]Xue C,Xie H,Eichenbaum J,et al. Synthesis of injectable shear-thinning biomaterials of various compositions of gelatin and synthetic silicate nanoplatelet[J]. Biotechnol J,2020,15(8):e1900456.
[33]Moore M J,Malaxos L,Doyle B J. Development of a shear-thinning biomaterial as an endovascular embolic agent for the treatment of type B aortic dissection[J]. J Mech Behav Biomed Mater,2019,99:66-77.
[34]Zandi N,Sani E S,Mostafavi E,et al. Nanoengineered shear-thinning and bioprintable hydrogel as a versatile platform for biomedical applications[J]. Biomaterials,2021,267:120476.
[35]Nigro V,Angelini R,Bertoldo M,et al. Chemical-physical behaviour of microgels made of interpenetrating polymer networks of PNIPAM and poly(acrylic acid)[J].Polymers,2021,13(9):1353.
[36]Liu B,Xu Z,Gao H,et al. Stiffness self-tuned shape memory hydrogels for embolization of aneurysms[J].Adv Funct Mater,2020,30(22):1910197.
[37]K?l??H,Ceylan D. Multi-responsive shape memory and self-healing hydrogels with gold and silver nanoparticles[J]. J Mater Chem B,2024,13(1):336-353.
[38]Liu M,Sun Y,Zhou Y,et al. A novel coacervate embolic agent for tumor chemoembolization[J]. Adv Healthc Mater,2024,13(19):e2304488.
[39]Back W,Rho J,Kim K,et al. An injectable fluorescent and iodinated hydrogel for preoperative localization and dual image-guided surgery of pulmonary nodules[J].Biomater Sci,2024,12(11):2943-2950.
[40]Pang Q,Xu Z,Sun T,et al. Strategic chemical synthesis and application of nanocarriers responsive to the tumor microenvironment[J]. Nano Today,2024,58:102421.
[41]Li X,Qian Y,Lu X,et al. Iodine-131 radioembolization boosts the immune activation enhanced by icaritin/resiquimod in hepatocellular carcinoma[J]. J Control Release,2025,378:849-863.
[42]Sorenson T,Brinjikji W,Lanzino G. Newer endovascular tools:a review of experimental and clinical aspects[J]. J Neurosurg Sci,2016,60(1):116-125.
[43]Fan M,Qiang L,Wang Y,et al. 3D bioprinted hydrogel/polymer scaffold with factor delivery and mechanical support for growth plate injury repair[J]. Front Bioeng Biotechnol,2023,11:1210786.
[44]Liu X ,Chen S ,Song Y ,et al. Interfacial roughnessreinforced magnetic nanosheet colloidal gels for stable embolization and magnetothermal therapy of hepatic tumor[J]. Adv Sci(Weinh),2025,12(36):e07096.
[45]Barakat A,Kamoun E A,El-Moslamy S H,et al. Photocurable carboxymethylcellulose composite hydrogel as a promising biomaterial for biomedical applications[J].Int J Biol Macromol,2022,207:1011-1021.
[46]Ao Y,Tang W,Tan H,et al. Hydrogel composed of typeⅡcollagen,chondroitin sulfate and hyaluronic acid for cartilage tissue engineering[J]. Biomed Mater Eng,2022,33(6):515-523.
[47]Chen B,Liang L,Jia D,et al. Inhibitory effect of RGD peptide hydrogel on inflammation and angiogenesis in vitro[J]. J Biomater Appl,2025,39(7):723-733.
[48]?irvinskas A,Smolskas E,Mikelis K,et al. Transcatheter arterial embolization for upper gastrointestinal tract bleeding[J]. Videosurgery Other Miniinvasive Tech,2017,12(4):385-393.
[49]H?rer T M,Ierardi A M,Carriero S,et al. Emergent vessel embolization for major traumatic and non-traumatic hemorrhage:Indications,tools and outcomes[J]. Semin Vasc Surg,2023,36(2):283-299.
[50]Gao J,Cao H,Hu G,et al. The mechanism and therapy of aortic aneurysms[J]. Sig Transduct Target Ther,2023,8(1):55.
[51]Fries F. New approaches to embolization of aneurysms(liquid embolic agents)[J]. Radiologe,2020,60(4):325-328.
[52]Kocer N ,Hanimoglu H ,Batur S ,et al. Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations[J]. Diagn Interv Radiol,2016,22(2):184-189.
[53]Rutledge C, Cooke D L, Hetts S W, et al. Brain arteriovenous malformations[J]. Handb Clin Neurol, 2021,176:171-178.
[54]Samaniego E A,Kalousek V,Abdo G,et al. Preliminary experience with precipitating hydrophobic injectable liquid(PHIL)in treating cerebral AVMs[J]. J Neurointerv Surg,2016,8(12):1253-1255.
[55]吴红星，李佑祥，杨小朋.脑动静脉畸形血管内栓塞的影响因素及治疗进展[J].中国医学科学院学报，2011,33(6):701-705.
[56]Nguyen Q V,Lym J S,Huynh C T,et al. A novel sulfamethazine-based pH-sensitive copolymer for injectable radiopaque embolic hydrogels with potential application in hepatocellular carcinoma therapy[J]. Polym Chem,2016,7(37):5805-5818.
[57]Shi X,Gao H,Dai F,et al. A thermoresponsive supramolecular copolymer hydrogel for the embolization of kidney arteries[J]. Biomater Sci,2016,4(11):1673-1681.
[58]Dunn C R,Lee B P,Rajachar R M. Thermomagneticresponsive self-folding microgrippers for improving minimally invasive surgical techniques and biopsies[J].Molecules,2022,27(16):5196.
[59]Li L,Liu Y,Li H,et al. Rational design of temperaturesensitive blood-vessel-embolic nanogels for improving hypoxic tumor microenvironment after transcatheter arterial embolization[J]. Theranostics,2018,8(22):6291-6306.
[60]Ozen M,Patel R,Hoffman M,et al. Update on endovascular therapy for fibroids and adenomyosis[J]. Semin Intervent Radiol,2023,40(4):327-334.
[61]Deipolyi A R,Zhang Y S,Khademhosseini A,et al.Portal vein embolization:impact of chemotherapy and genetic mutations[J]. J Clin Med,2017,6(3):26.
[62]Liu Y,Liu J,Zheng C,et al. Recent advances in embolic agents for transarterial chemoembolization of hepatocellular carcinoma[J]. Adv Healthc Mater,2026,15(10):e02566.
基本信息:
中图分类号:R815
引用信息:
[1]王帅南,郝媛,康磊,等.从传统到智能：介入栓塞剂的研究前沿及临床应用[J].赣南医科大学学报().
2026-06-04
2026-06-04
2026-06-04