A Safety and Performance Study of the Use of EmboBio for the Intra-arterial Treatment of Abdominopelvic Bleeding

Abdominopelvic bleeding may occur in different and various circumstances, in a spontaneous way, after a trauma, in a neoplasic context, after a visceral aneurysm's rupture, during or after a surgical treatment. They require fast and effective treatment, as they can be rapidly life-threatening, and that's where embolization steps in.

Embolization is a recent interventional radiology technique whose objective is the occlusion of arterial or venous vessels. Unlike so-called conventional surgical techniques, it is a minimally invasive treatment consisting in endovascular navigation using catheters and microcatheters to reach target vessels where the embolic agent is delivered. The choice of the embolic agent is guided by the indication of the procedure as well as the embolization site. Available permanent embolic agents include calibrated microparticles, metallic implants (coils, plugs) and bioglue. Although the ideal embolic agent does not exist, the choice of material remains a fundamental step in embolization procedures, and the development of new agents is an important avenue of research.

The choice of the embolic agent for bleeding control is based on the site of bleeding, the size of the artery, how fast the bleeding can be controlled but also the time required for embolic agent preparation, its price and the physician's preference. In this indication, the most often used permanent embolic agents are coils. Known adverse device effects of coils are risks of migration, non-target embolization, infection and damage to the wall vessels.

With the urgency of climate change and the demand for natural products in reaction to the overconsumption of chemicals for decades, both food and health industries have experienced a very strong demand for products with a biological process, both respectful of the environment in its design, and of the organism in its distribution. In this context, it seems appealing and important to develop new agents designed from new materials. Indeed, the use of organic materials is a game-changer that is both innovative and promising. More than these aspects, the development of organic embolic material seems necessary to improve the biocompatibility of implantable medical devices with the organism.

To conclude, the best embolic agent for abdominopelvic bleeding should provide a fast and effective long-term occlusion of the bleeding arteries, be safe, prepared speedily, easy to use, cheap and ecofriendly.

Embobio has been designed and developed to meet all these expectations. Embobio is the first organic agent designed for permanent embolization. We demonstrated in a preclinical study that this new agar-agar embolization implant is easy to use and effective in stopping bleeding in a hemorrhagic shock model, making it well-suited for emergency interventional radiology procedures.

Inclusion criteria

• Age ≥18 years
• Patient presenting with an arterial abdominopelvic bleeding or risk of bleeding requiring embolization with a permanent embolic agent, i.e. abdominal solid organs hemorrhage including angiomyolipoma, visceral aneurysms and pseudoaneurysms actively bleeding or at risk of bleeding (upper or lower gastrointestinal arteries), pelvic hemorrhage, postpartum hemorrhage in case of active leakage visualized by contrast media extravasation, soft tissue hemorrhage
• Patient having provided a written informed consent

Exclusion criteria

• Known hypersensitivity to Agar-Agar
• Known hypersensitivity to iodinated contrast media
• Patient unable or unwilling to provide a written informed consent
• Patient unable to provide informed consent due to his clinical condition
• Patient participating in another interventional study
• Patient implanted with Embobio device at a previous operating time
• Vulnerable, pregnant, and breastfeeding population
• Patient unwilling or unable to follow the study schedule
• Patients unable to receive prior information on the clinical investigation due to the urgency of the situation
• Target arteries diameter > 2 mm
• Vascular anatomy preventing proper placement of the catheter.
• Arteriovenous shunts with a high flow rate or a diameter greater than 2 mm