A systematic characterization of the factors influencing polymerization and dynamic behavior of n-butyl cyanoacrylate

Wang, Bill; Boulton, Melfort; Lee, Donald H.; Pelz, David M.; Lownie, Stephen P.

doi:10.1136/neurintsurg-2017-013009

Cited by 13 publications

(9 citation statements)

References 25 publications

(13 reference statements)

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“…When the microcatheter is not wedged into the vessel, NBCA runs through the vessel with arterial flow until it is polymerized. In previous reports, when NBCA was diluted to 50% with Lipiodol, the polymerization time of the 50% of the NBCA and Lipiodol mixture was six to ten seconds in the in-vitro experiments that could be replicated in the in-vivo environments under vessel wall interaction (23,24). In our experience, NBCA did not advance rapidly in the uterine artery because of its tortuosity.…”

Section: Discussionsupporting

confidence: 42%

Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate

Kwon

Kim

et al. 2019

J Korean Soc Radiol

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Purpose To evaluate the clinical efficacy and safety of uterine artery embolization (UAE) using N-butyl-2-cyanoacrylate (NBCA) in patients with postpartum hemorrhage (PPH). Materials and Methods From February 2010 to May 2018, 14 patients (age: 28-39 years; mean: 33 years) underwent UAE using NBCA among 82 patients with PPH. Medical records were retrospectively reviewed to evaluate the patients characteristics, cause of PPH, embolization procedure, and outcomes. Results Angiograms revealed extravasation (n = 10) or pseudoaneurysm (n = 4) in all patients. The causes of PPH were hysterotomy or hysterectomy related arterial injury (n = 11), cervical laceration (n = 2), and abnormal placentation (n = 1). UAE was performed with NBCA in all patients. Additional UAE with gelatin sponge particles was performed in two patients. Additional non-uterine artery embolization was performed in three patients. Coagulopathy was found in five (35.7%) patients. The technical and clinical success rates were 92.9% and 85.7%, respectively. One patient died from multi-organ failure eight days after UAE. One patient with abnormal placentation had pelvic organ ischemia due to multiple pelvic artery embolization. Conclusion UAE using NBCA is safe and effective for the patients with PPH showing extravasation or pseudoaneurysm.

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Section: Discussionsupporting

confidence: 42%

Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate

Kwon

Kim

et al. 2019

J Korean Soc Radiol

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“…Conventionally, the polymerization kinetics of cyanoacrylate-based mixtures are characterized by dropping glue mixtures onto blood substitutes or tissue samples [ 20 , 21 , 22 , 23 , 24 ]. The polymerization process is recorded by high-speed camera or video to monitor the morphologic changes.…”

Section: Discussionmentioning

confidence: 99%

“…The polymerization is considered to be triggered by nucleophiles leading to anionic or zwitterionic polymerization ( Figure 1 ). Some previous studies have measured the polymerization time of NBCA glues mixed with iodized oil [ 20 , 21 , 22 , 23 , 24 ]. The polymerization time is primarily evaluated by dropping NBCA/iodized oil mixture at different ratios onto blood plasma or tissue samples [ 20 , 21 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some previous studies have measured the polymerization time of NBCA glues mixed with iodized oil [ 20 , 21 , 22 , 23 , 24 ]. The polymerization time is primarily evaluated by dropping NBCA/iodized oil mixture at different ratios onto blood plasma or tissue samples [ 20 , 21 , 22 , 23 , 24 ]. The changes in polymer morphology or light transmittance are recorded with high-speed camera for characterizing the polymerization time.…”

Section: Introductionmentioning

confidence: 99%

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Raman Spectroscopic Characterization of Polymerization Kinetics of Cyanoacrylate Embolic Glues for Vascular Embolization

Xiao

Wang

et al. 2021

Polymers

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Endovascular glue embolization is a minimally invasive technique used to selectively reduce or block the blood supply to specific targeted vessels. Cyanoacrylate glues, mixed with radiopaque iodized oil, have been widely used for vascular embolization owing to their rapid polymerization rate, good penetration ability and low tissue toxicity. Nevertheless, in clinical practice, the selection of the glue–oil proportion and the manual injection process of mixtures are mostly based on empirical knowledge of operators, as the crucial physicochemical effect of polymerization kinetics has rarely been quantitatively investigated. In this study, the Raman spectroscopy is used for studying the polymerization kinetics of n-butyl-cyanoacrylate-based glues mixed with an iodized oil. To simulate the polymerization process during embolization, glue–oil mixtures upon contact with a protein ionic solution mimicking blood plasma are manually constructed and their polymerization kinetics are systematically characterized by Raman spectroscopy. The results demonstrate the feasibility of Raman spectroscopy in the characterization of polymerization kinetics of cyanoacrylate-based embolic glues. The polymerization process of cyanoacrylate-based mixtures consists of a fast polymerization phase followed by a slow phase. The propagation velocity and polymerization time primarily depend on the glue concentrations. The commonly used 50% mixture polymerizes 1 mm over ∼21.8 s, while it takes ∼51 min to extend to 5 mm. The results provide essential information for interventional radiologists to help them understand the polymerization kinetics of embolic glues and thus regulate the polymerization rate for effective embolization.

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“…Further, mixing NBCA with glacial acetic acid or ethanol, a preparation technique, modified the adhesive property of the material and achieved a slow and high amount of infusion [ 2 , 8 , 12 ]. Studies regarding temperature alteration addressed its effect on the mixture viscosity and the polymerization time [ 3 , 13 , 14 ], though the previously evaluated temperature range was limited and a more detailed study may help in better handling of the NBCA-iodized oil mixtures for lesions requiring peripheral delivery.…”

Section: Introductionmentioning

confidence: 99%

Effects of temperature alteration on viscosity, polymerization, and in-vivo arterial distribution of N-butyl cyanoacrylate-iodized oil mixtures

et al. 2021

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Purpose Temperature alteration can modify the polymerization of n-butyl cyanoacrylate (NBCA)-iodized oil mixtures during vascular embolization; its effects on viscosity, polymerization time, and intra-arterial distribution of the NBCA-iodized oil mixture were investigated. Materials and methods In vitro, the viscosities of NBCA, iodized oil, and NBCA-iodized oil mixtures (ratio, 1:1–8) were measured at 4–60 ºC using a rotational rheometer. The polymerization times (from contact with blood plasma to stasis) were recorded at 0–60 ºC using a high-speed video camera. In vivo, the 1:2 mixture was injected into rabbit renal arteries at 0, 20, and 60 ºC; intra-arterial distribution of the mixture was pathologically evaluated. Results The mixtures’ viscosities decreased as temperature increased; those at 60 ºC were almost four to five times lower than those at 4 ºC. The polymerization time of NBCA and the 1:1–4 mixtures increased as temperature decreased in the 0–30 ºC range; the degree of time prolongation increased as the percentage of iodized oil decreased. The 0 ºC group demonstrated distributions of the mixture within more peripheral arterial branches than the 20 and 60 ºC groups. Conclusion Warming reduces the mixture’s viscosity; cooling prolongs polymerization. Both can be potential factors to improve the handling of NBCA-iodized oil mixtures for lesions requiring peripheral delivery. Secondary abstract Temperature alteration influences the polymerization time, viscosity, and intra-arterial distribution of NBCA-iodized oil mixtures. Warming reduces the viscosity of the mixture, while cooling prolongs polymerization.

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A systematic characterization of the factors influencing polymerization and dynamic behavior of n-butyl cyanoacrylate

Abstract: The determinants of NBCA polymerization rate are multifactorial and dependent mainly on the presence of biological catalysts coupled with flow related wall interaction.

Cited by 13 publications

References 25 publications

Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate

Uterine Artery Embolization in Patients with Postpartum Hemorrhage: Clinical Efficacy and Safety of Treatment with N-Butyl-2-Cyanoacrylate

Raman Spectroscopic Characterization of Polymerization Kinetics of Cyanoacrylate Embolic Glues for Vascular Embolization

Effects of temperature alteration on viscosity, polymerization, and in-vivo arterial distribution of N-butyl cyanoacrylate-iodized oil mixtures

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