1
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Okuhira R, Higashino N, Sonomura T, Fukuda K, Koike M, Kamisako A, Tanaka R, Koyama T, Sato H, Ikoma A, Minamiguchi H. Balloon-Assisted Portal Vein Embolization Using n-Butyl-2-Cyanoacrylate-Lipiodol-Iopamidol Mixture in Swine: A Comparison of 2 Formulations. J Vasc Interv Radiol 2024; 35:462-468. [PMID: 38007178 DOI: 10.1016/j.jvir.2023.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 10/17/2023] [Accepted: 11/17/2023] [Indexed: 11/27/2023] Open
Abstract
PURPOSE To compare 2 ratios of n-butyl-2-cyanoacrylate (nBCA)-ethiodized oil (Lipiodol)-iopamidol (NLI) in balloon-assisted portal vein embolization (PVE) in swine. MATERIALS AND METHODS In an in vitro study, NLI prepared at a ratio of 2:3:1 (NLI231) or 1:4:1 (NLI141) was injected into 2.5- or 10-mL syringes filled with swine blood, and the viscosity of NLI was measured to determine an appropriate balloon occlusion time. Two portal vein branches in 8 female swine (n = 16 vein branches) were embolized with NLI231 (n = 8) or NLI141 (n = 8) under balloon occlusion. Portal venography was performed before, immediately after, and 3 days after PVE to evaluate the migration of NLI and the recanalization of embolized portal vein branches. Then, the livers were removed for histopathologic evaluation. RESULTS The times to peak viscosity of NLI231 in the 2.5- and 10-mL syringes were 55.8 seconds (SD ± 7.0) and 85.2 seconds (SD ± 6.3), and those to peak viscosity of NLI141 were 129.2 seconds (SD ± 11.8) and 254.0 seconds (SD ± 21.8), respectively. No migration of NLI231 was observed in all 8 procedures immediately or 3 days after PVE. Migration of NLI141 was observed in 6 of 8 procedures within 3 days after PVE. The migration frequency of the embolic material was lower in the NI231 group than in the NLI141 group (0/8 vs 6/8; P = .051). Histologically, NLI231 occupied the portal veins without any thrombi, whereas NLI141 was accompanied by thrombi in the portal veins. CONCLUSIONS NLI231 may be more suitable than NLI141 for balloon-assisted PVE in swine.
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Affiliation(s)
- Ryuta Okuhira
- Department of Radiology, Wakayama Medical University, Wakayama, Japan.
| | | | - Tetsuo Sonomura
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Kodai Fukuda
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Masataka Koike
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Atsufumi Kamisako
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Ryota Tanaka
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Takao Koyama
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Hirotatsu Sato
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Akira Ikoma
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
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Higashino N, Sonomura T, Ikoma A, Tamai K, Fukuda K, Kawai N, Minamiguchi H. Balloon-Assisted Arterial Embolization of Pseudoaneurysms Using NBCA-Lipiodol-Iopamidol Mixture in Two Clinical Cases. Cardiovasc Intervent Radiol 2024; 47:268-270. [PMID: 37875616 DOI: 10.1007/s00270-023-03571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/20/2023] [Indexed: 10/26/2023]
Affiliation(s)
- Nobuyuki Higashino
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan.
| | - Tetsuo Sonomura
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
| | - Akira Ikoma
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
| | - Kurumi Tamai
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
| | - Kodai Fukuda
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
| | - Nobuyuki Kawai
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
| | - Hiroki Minamiguchi
- Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan
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Ikoma A, Sonomura T, Higashino N, Fukuda K, Ihira H, Furotani H, Koike M, Sato H, Murata SI, Minamiguchi H. Feasibility of the Glue-in-Plug Technique Using a Novel Liquid Embolic Material in a Swine Model. J Vasc Interv Radiol 2023; 34:2233-2239. [PMID: 37678753 DOI: 10.1016/j.jvir.2023.08.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/24/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
PURPOSE To evaluate the feasibility of the glue-in-plug (GIP) technique using n-butyl-2-cyanoacrylate‒Lipiodol (NL)-iopamidol (NLI) for short-segment embolization in swine. MATERIALS AND METHODS The renal arteries, left external iliac artery, subclavian arteries, and common carotid arteries were each embolized in 4 swine using the GIP technique under general anesthesia. First, a type I Amplatzer vascular plug (AVP) (1-2 times the target vessel diameter) was deployed in the target artery. Next, the AVP was filled with NL mixture prepared at a ratio of 1:2 (NL12) (n = 11) or with NLI mixture prepared at a ratio of 2:3:1 (NLI231) (n = 11). Angiography was performed before, immediately after, and 1 hour after embolization to assess embolization and migration of the embolic materials. The embolized arteries were also evaluated histopathologically. RESULTS The migration distance of the embolic material beyond the plug tip was significantly shorter in the NLI231 group than in the NL12 group immediately after embolization (6.5 mm ± 4.5 vs 1.0 mm ± 1.8, P = .0024) and 1 hour after embolization (8.4 mm ± 5.6 vs 1.0 mm ± 1.8, P = .0013). Angiography revealed no sign of recanalization of the target vessels in any artery in either group. Mild inflammatory cell infiltration was observed around the arterial wall at the embolization site in all arteries in both groups. CONCLUSIONS The GIP technique using NLI231 may be a feasible procedure for short-segment embolization based on these short-term results.
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Affiliation(s)
- Akira Ikoma
- Department of Radiology, Wakayama Medical University, Wakayama, Japan.
| | - Tetsuo Sonomura
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | | | - Kodai Fukuda
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Hironobu Ihira
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Hiroki Furotani
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Masataka Koike
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Hirotatsu Sato
- Department of Radiology, Wakayama Medical University, Wakayama, Japan
| | - Shin-Ichi Murata
- Department of Human Pathology, Wakayama Medical University, Wakayama, Japan
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Guillen K, Comby PO, Oudot A, Salsac AV, Falvo N, Virely T, Poupardin O, Guillemin M, Chevallier O, Loffroy R. Iodixanol as a New Contrast Agent for Cyanoacrylate Embolization: A Preliminary In Vivo Swine Study. Biomedicines 2023; 11:3177. [PMID: 38137399 PMCID: PMC10740480 DOI: 10.3390/biomedicines11123177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
N-butyl cyanoacrylate (NBCA) is a lipophilic, permanent embolic glue that must be opacified for fluoroscopic guidance. Empirically, lipophilic Lipiodol Ultra Fluid® (LUF) has been added to produce a single-phase physically stable mixture. Varying the dilution ratio allows control of glue polymerization kinetics. LUF is far more costly than water-soluble iodinated contrast agents (ICAs). Our purpose was to evaluate whether a water-soluble nonionic iso-osmolar ICA could be used instead. We embolized both renal arteries of six swine using 1:3 NBCA-LUF or NBCA-iodixanol in 1:1, 1:3, and 1:7 ratios. We used both micro-computed tomography to assess the distality of glue penetration and indexed cast ratio and histology to assess distality, arterial obliteration, vessel-wall damage, and renal-parenchyma necrosis. Glue-LUF produced significantly greater indexed cast ratio and renal-artery ROI values and a significantly shorter cast-to-capsule distance. The injected volume was significantly greater with 1:7 iodixanol than with the other mixtures. No significant differences were found for histological evidence of artery obliteration, vessel-wall damage, or renal-parenchyma necrosis. This is the first study dealing with ICA alone as a contrast agent for cyanoacrylate embolization, compared to LUF. More research is needed to determine whether water-soluble nonionic iodinated agents can be used for human NBCA embolization given the good safety profile, availability, and low cost of ICA.
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Affiliation(s)
- Kévin Guillen
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Pierre-Olivier Comby
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Alexandra Oudot
- Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France; (A.O.); (M.G.)
| | - Anne-Virginie Salsac
- Biomechanics and Bioengineering Laboratory, UMR CNRS 7338, Technology University of Compiègne, 60203 Compiègne, France;
| | - Nicolas Falvo
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Thierry Virely
- Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France; (T.V.); (O.P.)
| | - Olivia Poupardin
- Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France; (T.V.); (O.P.)
| | - Mélanie Guillemin
- Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France; (A.O.); (M.G.)
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
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Guillen K, Salsac AV, Comby PO, Aho-Glele LS, Chevallier O, Loffroy R. In Vitro Characteristics of a Cyanoacrylate/Water-Soluble Contrast Emulsion: Preliminary Data from Light Microscopy Approach. Cardiovasc Intervent Radiol 2023; 46:1425-1427. [PMID: 37580425 DOI: 10.1007/s00270-023-03533-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/02/2023] [Indexed: 08/16/2023]
Affiliation(s)
- Kévin Guillen
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 210000, Dijon, France
| | - Anne-Virginie Salsac
- Biomechanics and Bioengineering Laboratory, UMR CNRS 7338, Université de Technologie de Compiègne, 60203, Compiègne, France
| | - Pierre-Olivier Comby
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 210000, Dijon, France
- Department of Neuroradiology and Emergency Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France
| | - Ludwig Serge Aho-Glele
- Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 210000, Dijon, France
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079, Dijon, France.
- ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 210000, Dijon, France.
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Fukamatsu F, Sugiura K, Takekoshi D, Fukuzawa T, Oyama K, Tsukahara Y, Kurozumi M, Shimizu A, Fujinaga Y. A ruptured splenic artery aneurysm treated by transcatheter arterial embolization using n-butyl cyanoacrylate-Lipiodol-Iopamidol. Radiol Case Rep 2023; 18:2385-2390. [PMID: 37179814 PMCID: PMC10172629 DOI: 10.1016/j.radcr.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/25/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023] Open
Abstract
N-butyl cyanoacrylate, one of embolic materials, is usually used as a mixture with Lipiodol (N-butyl cyanoacrylate-Lipiodol mixture). N-butyl cyanoacrylate-Lipiodol-Iopamidol was developed by adding a nonionic iodine contrast agent (Iopamiron) to N-butyl cyanoacrylate-Lipiodol mixture. N-butyl cyanoacrylate-Lipiodol-Iopamidol has lower adhesiveness than N-butyl cyanoacrylate-Lipiodol mixture and the ability to form a single large droplet. We report the case of a 63-year-old man with a ruptured splenic artery aneurysm treated by transcatheter arterial embolization using N-butyl cyanoacrylate-Lipiodol-Iopamidol. He was referred to the emergency room because of sudden onset of upper abdominal pain. A diagnosis was established using contrast-enhanced computed tomography and angiography. Emergency transcatheter arterial embolization was performed, and the ruptured splenic artery aneurysm was successfully embolized using a combination of coil framing and N-butyl cyanoacrylate-Lipiodol-Iopamidol packing. This case demonstrates the usefulness of a combination of coil framing and N-butyl cyanoacrylate-Lipiodol-Iopamdol packing for the embolization of aneurysms.
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Affiliation(s)
- Fumiaki Fukamatsu
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
- Corresponding author.
| | - Kazusa Sugiura
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Daiya Takekoshi
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Takuya Fukuzawa
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Kazuki Oyama
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Yoshinori Tsukahara
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Masahiro Kurozumi
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Akira Shimizu
- Division of Gastroenterological, Hepato-Biliary-Pancreatic, Transplantation and Pediatric Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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Gluing blood into gel by electrostatic interaction using a water-soluble polymer as an embolic agent. Proc Natl Acad Sci U S A 2022; 119:e2206685119. [PMID: 36215508 PMCID: PMC9586266 DOI: 10.1073/pnas.2206685119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Liquid embolic agents are widely used for the endovascular embolization of vascular conditions. However, embolization based on phase transition is limited by the adhesion of the microcatheter to the embolic agent, use of an organic solvent, unintentional catheter retention, and other complications. By mimicking thrombus formation, a water-soluble polymer that rapidly glues blood into a gel without triggering coagulation was developed. The polymer, which consists of cationic and aromatic residues with adjacent sequences, shows electrostatic adhesion with negatively charged blood substances in a physiological environment, while common polycations cannot. Aqueous polymer solutions are injectable through clinical microcatheters and needles. The formed blood gel neither adhered to the catheter nor blocked the port. Postoperative computed tomography imaging showed that the polymer can block the rat femoral artery in vivo and remain at the injection site without nontarget embolization. This study provides an alternative for the development of waterborne embolic agents.
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Fukuda K, Higashino N, Sonomura T, Okuhira R, Koike M, Ikoma A, Kawai N, Minamiguchi H. Determination of the Optimal Ratio and the Relationship Between Viscosity and Adhesion of n-Butyl Cyanoacrylate–Lipiodol–Iopamidol for Balloon-Assisted Embolization of Wide-Neck Aneurysms in Swine. Cardiovasc Intervent Radiol 2022; 45:357-364. [DOI: 10.1007/s00270-021-03055-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022]
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9
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Abaza M, Abdel-Aal AK, Almehmi A. Endovascular embolization for managing a massive shoulder arteriovenous malformation. Radiol Case Rep 2021; 16:3965-3968. [PMID: 34745404 PMCID: PMC8551750 DOI: 10.1016/j.radcr.2021.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/10/2022] Open
Abstract
Arteriovenous malformations (AVMs) are congenital high flow pathologic linkages between arteries and veins of different sizes that may occur in any part of the body. The clinical presentation is largely dependent on the size and location of AVMs and can range from an asymptomatic birthmark to congestive heart failure in extreme cases. In this report, we describe a 20-year-old male who presented with a large AVM of the right shoulder that resulted in significant cosmetic and physical impairment and treated with several sessions of endovascular embolization with good clinical outcomes. This case highlights the complexity of diagnosing and managing these AVMs. Most of these anomalies require a multi-disciplinary approach that integrates both trans-catheter and surgical interventions with trans-arterial lesion embolization being the cornerstone of the treatment.
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Affiliation(s)
- Masa Abaza
- Department of Biology, University of Alaska at Anchorage, Anchorage, AK, USA
| | - Ahmed K Abdel-Aal
- Department of Interventional Radiology, University of Texas at Houston, Houston, TX, USA
| | - Ammar Almehmi
- Department of Radiology and Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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10
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Comby PO, Guillen K, Chevallier O, Lenfant M, Pellegrinelli J, Falvo N, Midulla M, Loffroy R. Endovascular Use of Cyanoacrylate-Lipiodol Mixture for Peripheral Embolization: Properties, Techniques, Pitfalls, and Applications. J Clin Med 2021; 10:4320. [PMID: 34640339 PMCID: PMC8509239 DOI: 10.3390/jcm10194320] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/19/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Endovascular embolization agents are particles and fluids that can be released into the bloodstream through a catheter to mechanically and/or biologically occlude a target vessel, either temporarily or permanently. Vascular embolization agents are available as solids, liquids, and suspensions. Although liquid adhesives (glues) have been used as embolic agents for decades, experience with them for peripheral applications is generally limited. Cyanoacrylates are the main liquid adhesives used for endovascular interventions and have a major role in managing vascular abnormalities, bleeding, and many vascular diseases. They can only be injected as a mixture with ethiodized oil, which provides radiopacity and modulates the polymerization rate. This review describes the characteristics, properties, mechanisms of action, modalities of use, and indications of the cyanoacrylate-Lipiodol® combination for peripheral embolization.
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Affiliation(s)
- Pierre-Olivier Comby
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (P.-O.C.); (M.L.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Kévin Guillen
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Olivier Chevallier
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Marc Lenfant
- Department of Neuroradiology and Emergency Radiology, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (P.-O.C.); (M.L.)
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
| | - Julie Pellegrinelli
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Nicolas Falvo
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Marco Midulla
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
| | - Romaric Loffroy
- Imaging and Artificial Vision (ImViA) Laboratory-EA 7535, University of Bourgogne/Franche-Comté, 9 Avenue Alain Savary, BP 47870, 21078 Dijon, France; (K.G.); (O.C.)
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (J.P.); (N.F.); (M.M.)
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11
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Adjunctive Component to N-Butyl Cyanoacrylate-Lipiodol Mixture for Best Embolic Profile in Vivo: Ethanol or Iopamidol? Cardiovasc Intervent Radiol 2021; 44:1467-1468. [PMID: 34021376 DOI: 10.1007/s00270-021-02867-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/07/2021] [Indexed: 10/21/2022]
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12
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Fiani B, Soula M, Sarhadi K, Nikolaidis D, Gautam N, Fiani NJ, Jenkins R, Rose A. Direct N-butyl-2-cyanoacrylate injections to the head and neck for percutaneous embolized devascularization. Surg Neurol Int 2021; 12:131. [PMID: 33880236 PMCID: PMC8053456 DOI: 10.25259/sni_154_2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background: N-butyl-2-cyanoacrylate (NBCA) has been used for vascular malformations since the 1980s; however, few studies have looked at applications, procedural techniques, and outcome throughout many institutions. Herein, we review applications, procedural techniques, previous literature, and outcomes for the use of NBCA specifically through percutaneous technique in treating head and neck vascular pathology. Methods: An extensive literature review using PubMed database with published literature containing “N-butyl-2-cyanoacrylate embolization,” was performed. No date restrictions were used. Cross-checking of articles was conducted to exclude duplicate articles. The articles were screened for their full text and English language availability. We finalized those articles pertaining to the topic. Results: The search yielded 1124 related articles. When comparing surgical resection to embolization with NBCA for cerebral AVMs, complications were similar in both groups and included hemorrhage (15%), residual AVM (6%), and cerebrospinal fluid leak (3%). Their mortality rate was 3% in both groups. Preoperative percutaneous embolization does show improved surgical outcomes. Conclusion: NBCA is a fast-acting liquid embolic material used in the treatment of a variety of vascular malformations and lesions of the head and neck. Investigations surrounding the use of NBCA injections as a new alternative embolic agent began in the 1980’s. Administration of NBCA has been shown to be useful in minimizing intraoperative blood loss and controlling acute hemorrhage. Performing percutaneous embolization with NBCA provides a successful alternative for surgeons when transcatheter embolization techniques may prove to be too difficult to perform. Embolization using NBCA will continue to play in integral role in the treatment of malignant lesions and vascular malformations. Continued research is warranted to improve safety, outcomes, and further develop clinical applications of NBCA.
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Affiliation(s)
- Brian Fiani
- Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, California, United States
| | - Marisol Soula
- Grossman School of Medicine, New York University, New York, United States
| | - Kasra Sarhadi
- Department of Neurology, University of Washington, Main Hospital, Seattle, Washington State, United States
| | - Daniel Nikolaidis
- Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, United States
| | - Neha Gautam
- Department of Neurobiology, University of California Davis, Davis, California, United States
| | - Nicholas J Fiani
- Medical School, University of Medicine and Health Sciences, New York, United States
| | - Ryne Jenkins
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, California, United States
| | - Alexander Rose
- School of Medicine, University of New Mexico, Albuquerque, New Mexico, United States
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