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

Tanaka, Fumihiro; Kawai, Nobuyuki; Sato, Morio; Minamiguchi, Hiroki; Nakaï, Motoki; Nakata, Kenya; Sanda, Hiroki; Sonomura, Tetsuo

doi:10.1007/s11604-015-0451-0

Cited by 16 publications

(12 citation statements)

References 10 publications

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“…The characteristics of NLE have been shown to be different from those of the NBCA-lipiodol mixture (NL) (17,(26)(27)(28). NLE may have multiple advantages over NL for embolization, such as less adhesive properties to the catheter and less damage features to the vascular wall (26,27). NLE doesn't adhere to the balloon catheter and showed the feasibility of packing a wide-neck aneurysm (26,27).…”

Section: Discussionmentioning

confidence: 99%

“…NLE may have multiple advantages over NL for embolization, such as less adhesive properties to the catheter and less damage features to the vascular wall (26,27). NLE doesn't adhere to the balloon catheter and showed the feasibility of packing a wide-neck aneurysm (26,27). Ishikawa et al reported that NLE showed consistent and reproducible complete embolization with flow control compared to NL and was stable after balloon deflation (28).…”

Section: Discussionmentioning

confidence: 99%

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Type II endoleak model creation and intraoperative aneurysmal sac embolization with n-butyl cyanoacrylate-lipiodol-ethanol mixture (NLE) in swine

Nakaï¹,

Ikoma²,

Loffroy³

et al. 2018

Quant. Imaging Med. Surg

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Background: The purpose of this study was to evaluate the feasibility of type II endoleak model creation and efficacy of intraoperative aneurysmal sac embolization using n-butyl-2-cyanoacrylate-lipiodol-ethanol mixture (NLE) for type II endoleak in swine. Methods: In six swine (mean body weight 53.5 kg), abdominal aortic aneurysm (AAA) was created and then end-to-side anastomosis between the left renal artery and AAA sac was performed. And then, endovascular abdominal aortic aneurysm repair (EVAR) was performed, leading to creation of a type II endoleak model. As control group, EVAR without sac embolization was performed in two swine. In four swine, AAA sac was embolized using NLE immediately after EVAR via the microcatheter placed in AAA sac (NLE embolization group). Follow-up aortography was performed immediately and three days after the procedure, and then the aneurysms were extracted. Results: The AAA sac and type II endoleak model were successfully created in all cases. In control group, type II endoleak persisted three days after the procedure. In NLE embolization group, endoleak disappeared immediately and three days after the procedure. In NLE embolization group, AAA sac was occupied with thrombus and embolic material. Inflammatory changes were recognized in aneurysmal sac wall in NLE embolization group. Conclusions: This experimental study suggests that creation of a type II endoleak model in swine is feasible and that intraoperative AAA sac embolization with NLE during EVAR might reduce the occurrence of type II endoleak.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Type II endoleak model creation and intraoperative aneurysmal sac embolization with n-butyl cyanoacrylate-lipiodol-ethanol mixture (NLE) in swine

Nakaï¹,

Ikoma²,

Loffroy³

et al. 2018

Quant. Imaging Med. Surg

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“…However, we believe there is a small potential risk of the NBCA adhering to the balloon catheter in this procedure. Tanaka et al reported that the balloon catheter and microcatheter adhered strongly to the vessel in balloon-assisted packing of wide-neck aneurysms with NBCA-Lp mixture in an experimental study (Tanaka et al 2015 ). In our study, the neck of the pseudoaneurysms was narrow (2–3 mm).…”

Section: Discussionmentioning

confidence: 99%

Balloon-assisted Transcatheter arterial embolization using N-butyl cyanoacrylate for iatrogenic arterial bleeding by groin puncture: a new technology

et al. 2020

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Background: Balloon-assisted transcatheter arterial embolization (TAE) using n-butyl cyanoacrylate (NBCA) and lipiodol (Lp) mixture is a new endovascular treatment technique for iatrogenic arterial bleeding by groin puncture. It is less invasive compared to surgical repair, and NBCA migration into the circulation can be prevented by temporary balloon occlusion of the parent artery without ultrasound-guidance. This study aimed to report on the technical aspects and evaluate the efficacy and safety of fluoroscopically guided balloon-assisted transcatheter arterial embolization using NBCA for iatrogenic arterial bleeding by groin puncture. Materials and methods: The study included five patients (mean age 54.6 years; 3 male and 2 female) with iatrogenic arterial bleeding by groin puncture. We performed transcatheter arterial embolization using NBCA while occluding the responsible artery with a balloon catheter during the embolization to prevent NBCA migration. Two sheaths were inserted into the common femoral artery. A microcatheter was advanced into the pseudoaneurysm or extravasation via the contralateral sheath. A balloon catheter was advanced into the responsible artery until the balloon portion covered the leakage site via another sheath. After balloon inflation, the NBCA and Lip mixture was slowly injected until the pseudoaneurysm, or the extravasation was filled without touching the balloon. The microcatheter was removed immediately after the filling. We assessed technical success, overall success, and complications. Results: The injured arteries were the external iliac artery (n = 1), the common femoral artery (n = 2), and the proximal portion of the superficial femoral artery (n = 2). NBCA was injected once in four cases and twice in one case where complete hemostasis could not be achieved with one injection. The technical and overall success rate was 100% with no complications, including distal embolization of NBCA. Conclusions: Balloon-assisted TAE using NBCA is a feasible, effective, and safe treatment for iatrogenic arterial bleeding by groin puncture. It may also be applicable in other arterial bleeding situations where the potential risk of distal embolization can be decreased by applying the balloon-assisted technique.

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“…It has been reported that NLE is less adhesive than NBCA (6-8). Tanaka et al reported that NLE doesn't adhere to the balloon catheter and showed the feasibility of packing a wide-neck aneurysm (8). The major concern with NBCA is its adhesion to the catheter and early polymerization within the catheter and the proximal portion of the aneurysm, leading to incomplete embolization of the aneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…Incomplete embolization carries the risk of coil compaction and the recanalization of SAA (5). To overcome these limitations, we describe a new technique of endovascular liquid packing with balloon occlusion for SAA, using an n-butyl cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany)/lipiodol (Ultra-Fluide ® , Guerbet, Roissy, France)/ethanol (Fuso Pharmaceutical Industries Ltd, Osaka, Japan) (NLE) mixture, in which the addition of ethanol confers low adhesive properties on the NBCA glue (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

Transcatheter arterial embolization of a splenic artery aneurysm with N-butyl cyanoacrylate/lipiodol/ethanol mixture with coil-assisted sandwich technique

Ikoma¹,

Nakaï²,

Loffroy³

et al. 2019

Quant. Imaging Med. Surg

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

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

Cited by 16 publications

References 10 publications

Type II endoleak model creation and intraoperative aneurysmal sac embolization with n-butyl cyanoacrylate-lipiodol-ethanol mixture (NLE) in swine

Type II endoleak model creation and intraoperative aneurysmal sac embolization with n-butyl cyanoacrylate-lipiodol-ethanol mixture (NLE) in swine

Balloon-assisted Transcatheter arterial embolization using N-butyl cyanoacrylate for iatrogenic arterial bleeding by groin puncture: a new technology

Transcatheter arterial embolization of a splenic artery aneurysm with N-butyl cyanoacrylate/lipiodol/ethanol mixture with coil-assisted sandwich technique

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