Histopathological changes in brain arteriovenous malformations after embolization using Onyx or N-butyl cyanoacrylate

Natarajan, Sabareesh K.; Born, Donald E.; Ghodke, Basavaraj; Britz, Gavin W.; Sekhar, Laligam N.

doi:10.3171/2008.12.jns08441

Cited by 87 publications

(72 citation statements)

References 31 publications

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“…In a case of Onyx embolization with same-day surgical resection, no evidence of associated inflammatory infiltrate was noted. In four brain AVMs surgically resected one day after embolization, mild acute inflammatory reaction was seen in two cases (14,15). We observed moderate amount of vascular inflammation in cases 2 and 3, who were embolized with PHIL only.…”

Section: Discussionmentioning

confidence: 81%

See 1 more Smart Citation

Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

Koçer

Hanımoğlu²,

Batur³

et al. 2016

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 81%

“…6). Natarjan et al (15) reported the smallest vessel occluded by Onyx to be 5 μm with an average diameter of 81.4±103.8 µm. Jahan et al (14) reported blood vessels ranging from 80 µm to 1 mm in diameter filled with the embolic material.…”

Section: Discussionmentioning

confidence: 99%

Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

Koçer

Hanımoğlu²,

Batur³

et al. 2016

Diagn Interv Radiol

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“…Organ ischemia or patient-specific factors might be responsible for the pain experienced in some cases. Since the polymerization of NBCA involves an exothermic reaction, it can result in the destruction of the vessel wall and the perivascular tissue [39,64,126]. It also causes pain; however, the mechanism responsible for this is unknown.…”

Section: International Situationmentioning

confidence: 99%

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

et al. 2014

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“…In addition, adhesive liquid embolic materials (15)(16)(17)(18), including cyano acid isobutyl fatty acid and its derivatives, are most commonly used in clinical practice. However, their limitations include adhering easily to the high-molecular microcatheter, which subsequently blocks the catheter.…”

Section: Discussionmentioning

confidence: 99%

Experimental study of temperature-sensitive chitosan/β-glycerophosphate embolic material in embolizing the basicranial rete mirabile in swines

Ning

Zhao

Pang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The aim of the present study was to evaluate the feasibility of the non-adhesive temperature-sensitive liquid embolic material, chitosan/β-glycerophosphate (C/GP), in embolizing the basicranial rete mirabile (REM) in a swine model of cerebral arteriovenous malformation (cAVM). A total of 24 domestic swines were used as the experimental animals, among which 12 pigs underwent direct embolization of one side of the REM, while the other 12 pigs underwent embolization of the bilateral REM following anastomosis of the carotid artery and jugular vein. A super-selective microcatheter was introduced into the REM during the embolization procedure, and the C/GP hydrogel was injected until an image of the REM disappeared in the angiography examination. Further angiography examinations were performed after 2 and 6 weeks, and histological examination of the REM was performed after 6 weeks. Of the 24 domestic swines, 23 cases underwent successful thrombosis. Convulsions occurred in one case and that pig died during the embolization procedure. Following embolization, the angiography observations revealed that the embolized REM was no longer able to be developed, and adhesion of the microcatheter tip with the embolic agent did not occur. In addition, no apparent revascularization was observed in the angiography examinations performed at weeks 2 and 6. Therefore, the current preliminary study indicated that use of the non-adhesive temperature-sensitive embolic material was feasible for the embolization of cAVM; thus, C/GP may be used as an ideal embolic material for the treatment of cAVM. IntroductionCerebral arteriovenous malformation (cAVM) is the major cause of intracranial hemorrhage and seizures in young and middle-aged adults, and can seriously threaten their quality of life and life expectancy (1,2). Due to the minimal harm inflicted on patients, endovascular embolization therapy has become an important method for the treatment of cAVM, and the selection of an embolic material is a major determinant towards the treatment efficacy.The ideal cAVM embolic material should have a number of characteristics. Firstly, the material should be liquid, since this enables easy control, good dispersibility and ensures a sufficient injection time. Secondly, the material should exhibit a permanent embolism effect. Finally, the material should be non-toxic. Therefore, a non-adhesive liquid embolic material is ideal. In recent years, this particular material had received considerable attention in the field of endovascular treatment (3).Therefore, the present study investigated chitosan/β-glycerophosphate (C/GP) as the base material. The C/GP solution is liquid at room temperature, but forms a hydrogel at 37.0˚C (body temperature). In addition, the pH of the C/GP solution is compatible with the physiological requests. These two materials have been previously demonstrated to be safe and non-toxic (4); however, the combination of C/GP has not been utilized in previous studies as a non-adhesive temperature-sensitive liquid embolic mat...

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Histopathological changes in brain arteriovenous malformations after embolization using Onyx or N-butyl cyanoacrylate

Cited by 87 publications

References 31 publications

Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

Experimental study of temperature-sensitive chitosan/β-glycerophosphate embolic material in embolizing the basicranial rete mirabile in swines

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