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Tanoue S, Tanaka N, Koganemaru M, Kuhara A, Kugiyama T, Sawano M, Abe T. Head and Neck Arteriovenous Malformations: Clinical Manifestations and Endovascular Treatments. INTERVENTIONAL RADIOLOGY (HIGASHIMATSUYAMA-SHI (JAPAN) 2023; 8:23-35. [PMID: 37485489 PMCID: PMC10359175 DOI: 10.22575/interventionalradiology.2022-0009] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 04/01/2022] [Indexed: 07/25/2023]
Abstract
Arteriovenous malformations (AVMs) are vascular malformations that present high-flow direct communication between the arteries and veins, not involving the capillary beds. They can be progressive and lead to various manifestations, including abnormal skin or mucosal findings, ischemia, hemorrhage, and high-output heart failure in severe cases. AVMs often involve the head and neck region. Head and neck AVMs can present region-specific clinical manifestations, angioarchitecture, and complications, especially in cosmetic appearance and ingestion, respiratory, and neuronal functions. Therefore, when planning endovascular treatment of head and neck AVMs, physicians should consider not only the treatment strategy but also the preservation of the cosmetic appearance and critical functions. Knowledge of the functional vascular anatomy as well as treatment techniques should facilitate a successful management. This review summarizes AVMs' clinical manifestations, imaging findings, treatment strategy, and complications.
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Affiliation(s)
- Shuichi Tanoue
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Norimitsu Tanaka
- Department of Radiology, Kurume University School of Medicine, Japan
| | | | - Asako Kuhara
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Tomoko Kugiyama
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Miyuki Sawano
- Department of Radiology, Kurume University School of Medicine, Japan
| | - Toshi Abe
- Department of Radiology, Kurume University School of Medicine, Japan
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Seo JW, Park H, Kim D, Lee S, Koh YG, Kim JY, Park I, Lee W. In Vivo Animal Study of a Highly Viscous N-butyl Cyanoacrylate Medical Adhesive for Intravenous Embolization. MATERIALS 2021; 14:ma14133527. [PMID: 34202769 PMCID: PMC8269526 DOI: 10.3390/ma14133527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/10/2021] [Accepted: 06/17/2021] [Indexed: 11/16/2022]
Abstract
N-butyl cyanoacrylate (NBCA) is a liquid monomer that undergoes an exothermic polymerization reaction to form a solid upon initiation with hydroxyl anions. Recently, EGpresto, a highly viscous NBCA-based adhesive, has been developed for vascular-occlusion purposes. In this study, we investigated the heat of polymerization of EGpresto and compared the results with those of a low-viscosity NBCA glue. Results show that EGpresto exhibited a lower heat of polymerization (64 ± 7 °C vs. 34 ± 1 °C). This was due to its high viscosity, which resulted in a delayed polymerization time. To investigate the efficacy and safety of EGpresto for intravenous embolization, a 14 d in vivo animal test was conducted using three pigs. Five cc of EGpresto was injected into the epigastric vein of each animal. Complete postoperative vein occlusion was confirmed at 7 and 14 d by ultrasonographic visualization. After the animals were sacrificed, the operated and unoperated veins were exposed, and the injected adhesive was found without migration. During the histology, the injected adhesive was not found in the inner or outer vein walls, and the immune reactions seemed to be the only foreign-body reaction, showing that EGpresto is a non-toxic and safe intravascular embolic agent.
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Affiliation(s)
- Jae-Won Seo
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
| | - Habeen Park
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
- Department of Chemistry, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
| | - Dogeun Kim
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
| | - Seoyun Lee
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
| | - Young Gook Koh
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
| | - Jang Yong Kim
- Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Insoo Park
- Charm Vascular Clinic, 1814 Nambu-sunhwan-ro, Gwanak-gu, Seoul 08787, Korea;
| | - Wonmok Lee
- ENGAIN Co. Ltd., 700, Daewangpangyo-ro, Bundang-gu, Seongnam 13488, Gyeonggi-do, Korea; (J.-W.S.); (H.P.); (D.K.); (S.L.); (Y.G.K.)
- Department of Chemistry, Sejong University, 209, Neungdong-ro, Gwangjin-gu, Seoul 05006, Korea
- Correspondence: ; Tel.: +82-10-4914-3598
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