nach oben

Erschienen in:

01.08.2015 | Technical Note

Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study

verfasst von: Fumihiro Tanaka, Nobuyuki Kawai, Morio Sato, Hiroki Minamiguchi, Motoki Nakai, Kouhei Nakata, Hiroki Sanda, Tetsuo Sonomura

Erschienen in: Japanese Journal of Radiology | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To evaluate the feasibility of balloon-assisted packing with a mixture of n-butyl cyanoacrylate (NBCA), Lipiodol, and ethanol for wide-neck aneurysms.

Materials and methods

Of 10 carotid aneurysms with wide necks created in a swine model, 3 aneurysms (long and short diameters 10.9 × 9.8 mm; neck width 8.3 ± 1.2 mm (mean ± SD)) and 7 aneurysms (11.2 × 9.5 mm; neck width 8.3 ± 1.4 mm) were packed with a mixture of NBCA, Lipiodol, and ethanol in the ratios 1:1:0 (NL11) and 1:1:2 (NLE112), respectively. A microcatheter was advanced into the aneurysm and a balloon catheter was inflated at the aneurysm neck. Ten minutes after injection, the balloon catheter was deflated and its removal was attempted.

Results

For all three aneurysms in the NL11 group, the balloon catheter and the microcatheter adhered strongly to the vessel and could not be adjusted. For all seven aneurysms in the NLE112 group, both the balloon catheter and the microcatheter could be easily removed, which enabled successful full packing of the aneurysm by re-advancing the microcatheter and re-injecting NLE112 after re-inflation of the balloon catheter.

Conclusion

Although at a preliminary stage, balloon-assisted NLE injection is feasible for packing a wide-neck aneurysm.

American Society for Gastrointestinal Endoscopy Assessment Committee Technology. Status evaluation report: tissue adhesives and fibrin glues. Gastrointest Endosc. 2004;60:327–33.CrossRef

Stoesslein F, Ditscherlein G, Romaniuk PA. Experimental studies on new liquid embolization mixtures (histoacryl-Lipiodol, histoacryl-panthopaque). Cardiovasc Intervent Radiol. 1982;5:264–7.CrossRefPubMed

Spiegel SM, Vinuela F, Goldwasser JM, Fox AJ, Pelz DM. Adjusting the polymerization time of isobutyl-2 cyanoacrylate. AJNR Am J Neuroradiol. 1986;7:109–12.PubMed

Gounis MJ, Lieber BB, Wakhloo AK, Siekmann R, Hopkins LN. Effect of glacial acetic acid and ethiodized oil concentration on embolization with n-butyl 2-cyanoacrylate: an in vivo investigation. AJNR Am J Neuroradiol. 2002;23:938–44.PubMed

Kawai N, Sato M, Minamiguchi H, Ikoma A, Sanda H, Nakata K, et al. Basic study of a mixture of n-butyl cyanoacrylate, ethanol, and Lipiodol as a new embolic material. J Vasc Radiol. 2012;23:1516–21.CrossRef

Toyoda H, Nakano S, Kumada T, Takeda I, Sugiyama K, Osada T, et al. Estimation of n-butyl-2 cyanoacrylate-Lipiodol mixture in transcatheter arterial embolization for urgent control of life-threatening massive bleeding from gastric or duodenal ulcer. J Gastr Hepat. 1996;11:252–8.CrossRef

Kish JW, Katz MD, Marx V, Harrell DS, Hanks SE. n-Butyl cyanoacrylate embolization for control of acute arterial hemorrhage. J Vasc Interv Radiol. 2004;15:689–95.CrossRefPubMed

Yonemitsu T, Kawai N, Sato M, Tanihata H, Takasaka I, Nakai M, et al. Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition. J Vasc Interv Radiol. 2009;20:1176–87.CrossRefPubMed

Debrun GM, Aletich VA, Shownkeen H, Ausman J. Glued catheters during embolization of brain AVMs with acrylic glue. Interv Neuroradiol. 1997;30:13–9.

10.

The n-BCA trial investigation. n-Butyl cyanoacrylate embolization of cerebral arteriovenous malformations: results of a prospective, randomized, multi-center trial. AJNR Am J Neuroradiol. 2002;23:748–55.

11.

Zubillage AF, Guglielmi G, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol. 1994;15:815–20.

12.

Debrun GM, Aletich VA, Kehrli P, Misra M, Ausman JI, Charbel F. Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery. 1998;43:1281–95.PubMed

13.

Gad SC. Pharmaceutical manufacturing handbook. Production and processes. Hoboken: Wiley; 2008. p. 364–7.CrossRef

14.

Miller CA. Spontaneous emulsification produced by diffusion—a review. Colloids Surf. 1988;29:89–102.CrossRef

Titel: Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study
verfasst von: Fumihiro Tanaka
Nobuyuki Kawai
Morio Sato
Hiroki Minamiguchi
Motoki Nakai
Kouhei Nakata
Hiroki Sanda
Tetsuo Sonomura
Publikationsdatum: 01.08.2015
Verlag: Springer Japan
Erschienen in: Japanese Journal of Radiology / Ausgabe 8/2015
Print ISSN: 1867-1071
Elektronische ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-015-0451-0

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Chronische Unterbauch- und Viszeralschmerzen in der Praxis managen"

Springer Medizin

Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study