Toward More Predictable Musculoskeletal Embolization: A Translational Evaluation of Imipenem–Cilastatin Performance and Safety in a Porcine Model of Tendon Neovascularization

Background

There is a need to provide a translational evaluation of imipenem–cilastatin as an innovative musculoskeletal embolic agent by assessing its embolization efficacy, physicochemical behavior, and safety profile in a porcine model of intratendinous neovascularization. Materials and Methods: In vitro analyses were performed to assess size distribution and solubility of imipenem–cilastatin in iodinated contrast media (Visipaque®) for two commercial formulations (Tienam® and Sun®). A preclinical study was conducted on six pigs, with neovascularization induced via collagenase injection in the patellar tendon. Each animal received Tienam® embolization with Visipaque® on one side and Visipaque® alone on the contralateral side at D7 post induction, followed by angiographic evaluation at D14. Efficacy was assessed using a four-point neovascularization score. Safety was evaluated through behavioral monitoring and rectal flora analysis.