Direct thrombosis of aneurysms with cellulose acetate polymer

Abstract

The authors report the treatment of seven intracranial aneurysms in six patients with direct infusion of cellulose acetate polymer solution, a new liquid thrombotic material. These aneurysms were considered inoperable because of their size or location, or because of the patient's neurological condition. This material avoids the difficulties associated with balloon occlusion, and completely fills even irregularly shaped aneurysms. Cellulose acetate polymer solution hardens in about 5 minutes and remains solid once inside the aneurysm. Because this technique is less invasive than surgery, it can be used for high-risk patients in the acute stage of subarachnoid hemorrhage. Transient motor aphasia occurred in one patient. A small residual neck, which caused rebleeding 3 months after the treatment, remained in another patient. This article describes the new material, the procedure for direct thrombosis, and preliminary clinical results.

Guidelines for the management of aneurysmal subarachnoid hemorrhage. A statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association.

“…Similar uncontrolled reports have described aneurysm thrombosis with polymers. 105 Long-term follow-up (particularly of partially occluded aneurysms) and control of selection criteria are needed to compare balloon embolization with other treatment modalities for preventing rebleeding after SAH.…”

Accuracy and interobserver reliability of three-dimensional rotational angiography versus mathematical models for volumetric measurement of intracranial aneurysms

“…1 Liquid embolic polymers are also emerging as a potential alternative to coiling, to achieve better filling of the aneurysm sac. [13][14][15][16][17][18][19][20] These methods may also substantially benefit from the volumetric assessment of the aneurysm cavity. 21 The accuracy of 3D-RA has been assessed using both iron balls 1 and phantom models.…”

Embolization of cerebral aneurysms with a liquid embolus, EVAL mixture: Report of three cases

“…If distal emboli from a liquid embolus could be minimized during embolization of aneurysms, it would be an ideal embolic material. There is one report concerning embolization of cerebral aneurysms with liquid emboli [9]. We have experience of embolizations of surgically difficult aneurysms with a non-adhesive liquid embolus, EVAL mixture (Ethylene vinyl alcohol copolymer) [18].…”