Experimental catheter obstruction of the gastric coronary vein. Possible technique for percutaneous intravascular tamponade of the gastroesophageal varices

Experimental catheter obstruction of the left gastric (coronary) vein was explored in 10 dogs. Using a transjugular approach, the liver was punctured and the portal vein catheterized. Coaxially introduced catheters were then used to catheterize selectively and produce an intravascular obstruction (tamponade) of the gastric coronary vein. Ballon catheters were used for a temporary occlusion. Injection of a tissue adhesive, isobutyl 2-cyanoacrylate, was used for a definitive obliteration. The achieved results show the anatomical feasibility of this approach and give good perspective for development of a clinical method for percutaneous intravascular tamponade of the bleeding gastroesophageal varices in cirrhotics.

Experimental evaluation of a tissue adhesive as an agent for the treatment of aneurysms and arteriovenous anomalies

✓ Studies were performed on adult mongrel dogs to evaluate the possibility of occluding saccular aneurysms and arteriovenous (AV) anomalies with an intravascular injection of the tissue adhesive isobutyl-2-cyanoacrylate (IBC). Twelve normal canine renal arteries, four surgically constructed AV fistulas, and six surgically constructed vein pouch aneurysms were occluded by the injection of IBC through a fluoroscopically positioned intra-arterial catheter. The IBC was also directly injected into 25 surgically constructed vein pouch aneurysms. Angiography performed immediately after injection and up to 3 months following treatment revealed persistent occlusion of the renal arteries, arteriovenous fistulas, and aneurysms. Tissue reaction to the IBC was mild and confined to the intima in these experiments. Further investigation of this procedure for the treatment of aneurysms and arteriovenous anomalies by either a stereotaxic or selective catheterization technique is suggested.