Preoperative Embolization of Venous Malformations Using <i>n</i>-Butyl Cyanoacrylate

Uller, Wibke; Elsobky, Sherif; Alomari, Ahmad I.; Fishman, Steven J.; Spencer, Samantha A.; Taghinia, Amir H.

doi:10.1177/1538574418762192

Cited by 19 publications

(10 citation statements)

References 15 publications

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“…EPO is also used to prepare sclerosing agents or embolics for the treatment of vascular anomalies. Uller et al gave evidence that preoperative embolization of venous malformations using NBCA with EPO as contrast agent was safe and effective in children, with the potential for minimizing blood loss and inpatient stay [35].…”

Section: Discussionmentioning

confidence: 99%

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

et al. 2021

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Background: There is a sparsity of data on the use of ethiodized poppy seed oil (EPO) contrast agent (Lipiodol) in patients. We investigated the safety of EPO in children, adolescents, and some adults for diagnostic and therapeutic interventions. Methods: All patients who underwent procedures with EPO between 1995 and 2014 were retrospectively included. Demographic characteristics, diagnosis, dose, route of administration, preparation of EPO in combination with other agents, and complications were recorded. Results: In 1422 procedures, EPO was used for diagnostic or treatment purposes performed in 683 patients. The mean patient age was 13.4 years (range: 2 months–50 years); 58% of patients were female. Venous malformations (n = 402, 58.9%) and arteriovenous malformations (n = 60, 8.8%) were the most common diagnosis. Combined vascular anomalies included capillary–lymphatic–venous malformations, fibroadipose vascular anomalies (n = 54, 7.9%), central conducting lymphatic anomalies (n = 31, 4.5%), lymphatic malformations (n = 24, 3.5%), aneurysmal bone cysts (n = 22, 3.2%), and vascularized tumors (n = 11, 1.6%). In 1384 procedures (96%), EPO was used in various combinations with sclerosing and embolization agents, including sodium tetradecyl sulfate, ethanol, and glue. The mean volume of EPO used in interventions was 3.85 mL (range: 0.1–25 mL) per procedure with a mean patient weight of 45.9 kg (range: 3.7–122.6 kg) and a weight-adjusted dose of 0.12 mL/kg (range: 0.001–1.73 mL/kg). In 56 procedures (4%), EPO was used as a single agent for diagnostic lymphangiography. The mean volume was 4.8 mL (range: 0.3–13 mL) per procedure with a mean patient weight of 27.4 kg (range: 2.4–79.3 kg) and a weight-adjusted dose of 0.2 mL/kg (range: 0.04–0.54 mL/kg). Procedural-related complications occurred in 25 (1.8%) procedures. The 20 minor and 5 major complications were related to the primary treatment agents. None of them were directly related to EPO. No allergic reactions were noted. Conclusion: The use of an ethiodized poppy seed oil contrast agent in children, adolescents, and adults for diagnostic or therapeutic purposes is safe.

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Section: Discussionmentioning

confidence: 99%

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

et al. 2021

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“… 11 Recently, embolization with n-butyl cyanoacrylate was reported as an alternative option. 6 , 11 , 12 Embolization will better define the lesion's margins and decrease the risk of bleeding after surgical resection. 12 If venography had been performed and the thrombus formation in the draining vein had been found, preoperative embolization and surgical resection would have been alternative management options for our patient.…”

Section: Discussionmentioning

confidence: 99%

Lethal prognosis of an infant with intraperitoneal large venous malformation

Ouchi

Tsuchiya

Iehara

et al. 2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Another therapeutic approach is to embolize the VM adjacent to the knee joint with N-butyl-2cyanoacrylate to control bleeding and to facilitate surgical resection [25] . Uller et al embolized with this technique seven intra-articular VMs of the knee prior to resection with a follow-up time ranged between 0.2 to years [26]. lt remains unclear, if this measure really helps to prevent 17 18 21 22 24 from hemarthrosis and consecutive osteoarthropathy in the long term.…”

Section: Discussionmentioning

confidence: 99%

MR Features of Juxta-Articular Venous Malformations of the Knee to Predict the Clinical Outcome of Sclerotherapy

Gnannt

Guggenberger

Mueller

et al. 2020

Journal of Vascular and Interventional Radiology

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PURPOSE To analyze and correlate preinterventional magnetic resonance (MR) imaging findings with clinical symptoms after percutaneous sclerotherapy of venous malformations (VMs) adjacent to the knee. MATERIALS AND METHODS Twenty-five patients (mean age, 24 y; range, 7-55 y; 11 female) with 26 VMs adjacent to the knee undergoing sclerotherapy (direct puncture, diagnostic angiography, sclerosant injection) were identified, and MR imaging findings were analyzed. The VM involved the synovium of the knee joint in 19 of 26 cases (76%). These lesions were associated with joint effusion (3 of 19; 16%), hemarthrosis (4 of 19; 21%), or synovial thickening (16 of 19; 84%). Follow-up ended 6-8 weeks after the first or second sclerotherapy session if complete pain relief was achieved or 3 months after the third sclerotherapy session. Treatment outcomes were categorized as symptom improvement (complete or partial pain relief) or poor response (unchanged or increased pain). RESULTS Forty-nine percutaneous sclerotherapy sessions were performed. Despite the absence of signs of knee osteoarthritis, patients with a VM involving the synovium (8 of 14; 57%) showed a poor response to sclerotherapy (1 of 8 [13%] pain-free after 1 sclerotherapy session). Among patients with VMs with no associated joint alteration and no synovial involvement (6 of 14; 43%), 5 of 6 (83%) showed improvement of symptoms after 1 sclerotherapy session (P < .05). CONCLUSIONS Juxta-articular VMs of the knee are frequently associated with hemarthrosis and synovial thickening. Patients with signs of osteoarthritis and synovial involvement of the VM on presclerotherapy MR imaging deserve special consideration, as these findings predict worse clinical symptoms after sclerotherapy.

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Preoperative Embolization of Venous Malformations Using n-Butyl Cyanoacrylate

Abstract: Initial results suggest that preoperative percutaneous n-butyl cyanoacrylate embolization of venous malformations is safe and effective in children, with the potential for minimizing blood loss and inpatient stay.

Cited by 19 publications

References 15 publications

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

Lethal prognosis of an infant with intraperitoneal large venous malformation

MR Features of Juxta-Articular Venous Malformations of the Knee to Predict the Clinical Outcome of Sclerotherapy

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