Sclerosis and varicocele embolization with N-butyl cyanoacrylate: experience in 41 patients

Urbano, José; Cabrera, Manuel López; Alonso‐Burgos, Alberto

doi:10.1177/0284185113493774

Cited by 28 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the interventional radiology literature, technical and clinical success rates of 80-100% (9,12,13,15) in both sclerotherapy and embolization have been reported, which are consistent with our technical and clinical success rates of 100% and 91.2%, respectively. Among the endovascular methods, coils are the most commonly used because they are safe, easy to handle and readily available (8,17).…”

Section: Discussionsupporting

confidence: 91%

“…Indeed, percutaneous embolization has the advantage of being an outpatient procedure with a faster return to normal activities, a considerably lower cost and a lower recurrence rate than is the case for surgery (6). The use of many different embolic agents, such as gelatin sponge, stainless steel coils, Amplatzer vascular plugs, detachable balloons, cyanoacrylate glues or sclerosing agents has been reported (7)(8)(9)(10)(11)(12)(13)(14)(15). However, to our knowledge, there are no data in the literature regarding the comparison of the different embolic materials currently available on the market for the treatment of varicocele in terms of efficacy, tolerance, radiation and recurrence rates.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate

Loffroy¹,

Mourey²,

Genson³

et al. 2016

Journal of Vascular and Interventional Radiology

View full text Add to dashboard Cite

Background: To evaluate pain, radiation and recurrence rates in patients undergoing varicocele embolization with three different embolic materials.Methods: Retrospective study of 182 consecutive patients who underwent transcatheter retrograde varicocele embolization from July 2011 to May 2015 with glue (Glubran ® 2) (group 1, n=63), mechanical agents (coils and/or plugs) (group 2, n=53) or a sclerosing agent (polidocanol) (group 3, n=66). Patients were asked by telephone interview to evaluate pain during embolization and at 1, 7 and 30 days using a quantitative pain scale ranging from 0 to 10. Duration of scopy, kinetic energy released per unit mass (kerma) and dose area product (DAP) were assessed as radiation parameters during embolization procedures.Recurrence rates after treatment were also evaluated. Statistical analyses were performed using parametric and non-parametric tests.Results: Patients in the three study groups were comparable for age, clinical indication and embolization side. No difference was noted for significant pain (pain score ≥3) during embolization and at 1, 7 and 30 days after treatment. Discomfort (pain score <3) was more frequent in group 1 than in groups 2 and 3 at 7 days after the procedure (P=0.049). No difference in discomfort was noted during embolization or at 1 and 30 days. Duration of scopy was shorter (P<0.0001) and kerma was lower (P=0.0087) in group 1 than in groups 2 and 3. DAP was lower in group 1 than in group 2 (P=0.04) but no difference was noted between groups 1 and 3, and groups 2 and 3. The recurrence rate at a mean follow-up of 24.4 months (range, 2-53 months)was significantly lower in group 1 than in the two other groups (P=0.032).Conclusions: The use of Glubran ® 2 acrylic glue for varicocele embolization is safe and leads to less radiation and lower recurrence rates than is the case for other embolic materials without any more significant pain.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate

Loffroy¹,

Mourey²,

Genson³

et al. 2016

Journal of Vascular and Interventional Radiology

View full text Add to dashboard Cite

show abstract

“…N-butyl-cyanoacrylate is clinically used as tissue adhesive in wound therapy and for blood vessel embolization [10,19,20]. It has also found its way into urology as a sclerosing agent in varicocele treatment [19], a therapy offering further advantages: first by putting the coil in place, the clinician can determine the exact location of the occlusion region and have it radiologically verified if necessary, a method perhaps not possible using the n-butyl-cyanoacrylate alone. Second, the coil acts as an additional barrier and enlarges the surface area in which the substance can po- lymerize, potentially causing a tighter occlusion.…”

Section: Discussionmentioning

confidence: 99%

Is Endoscopic Vasectomy Just a Dream: An ex vivo Study on Feasibility and Reliability of Endoluminal Occlusion of Porcine Vas Deferens

Schlager

Maas²,

Hein³

et al. 2017

Urol Int

View full text Add to dashboard Cite

Introduction and Aim: Surgical vasectomy remains the gold standard for fertility control in men. Endoluminal occlusion of the seminal ducts, thus avoiding an external incision, may become an appealing alternative to this approach. As our group has shown, nontraumatic endoscopic inspection of the seminal ducts is feasible in the human cadaver. We investigated the feasibility and reliability of occlusion using several commercially available medical sealing agents in the porcine vas deferens (VD). Methods and Main Outcome Measures: Tests were conducted using 25 porcine spermatic ducts (10 cm length) ex vivo. The explanted specimens were fixed and cannulated using the Seldinger technique. We administered 5 different agents (n-butyle-2-cyanoacrylate, n-butyle-2-cyanoacrylate in combination with a platinum vascular coil, Tissucol Duo S®, Gelita Spon® and AFP Plug®) endoluminally. Tightness was evaluated after 5, 15, 60, 360, 720, and 1,440 min for each of the five grades, respectively, using a solution of methylene blue and saline injected under controlled pressure of 300 mm Hg followed by histological examination. Results: All agents were administered into the porcine seminal ducts (4 out of 5 via a ureteric catheter). Gelita Spon® and Tissucol Duo S® did not occlude the lumen sufficiently, whereas n-butyle-2-cyanoacrylate, n-butyle-2-cyanoacrylate in combination with coil, Tissucol Duo and AFP Plug® performed satisfactorily. In particular, cyanoacrylate combined with a coil was able to close the seminal duct tightly and for a long time. Histological findings confirmed this sealant's gapless adhesion. AFP Plug® application revealed similarly good results. However, its form needs to be optimized to ensure its suitability for endoscopic use. Conclusion: Various developments regarding minimally invasive fertility control methods have been underway for decades. Further miniaturization of endoscopy and novel materials may pave the way for endoscopic fertility control in males in the future. We demonstrated the potential of commercially available medical sealing agents to reliably occlude the porcine VD.

show abstract

“…Only embolization with high viscosity liquids (glue) has a reported low technical failure rate (<1%) and lower recurrence rates (< 2%) [10,23,36,37]. The low technical failure rate is probably related to the use of a coaxial catheter system.…”

Section: Non-liquid Embolicsmentioning

confidence: 99%

“…First, a German group from Berlin embolized 30 patients with NBCA mixed with Lipiodol with a technical success of 100% and a recurrence rate of 6% [41]. More recent reports showed a very high technical success (100%), very few complications (0-1.2%) and low recurrences (0-2.1%) [10,23,42,43].…”

Section: Embolization Of Varicoceles With Cyanoacrylatesmentioning

confidence: 99%

Contribution to the Pathophysiology and Treatment of Varicoceles

Vanlangenhove¹

2018

Journal of the Belgian Society of Radiology

View full text Add to dashboard Cite

Anatomical differences between adults and adolescents and between left and right varicoceles were shown in this work. We designed a standardized and reproducible method for pressure measurement in the inguinal internal spermatic vein (ISV). We demonstrated that the mean absolute pressure in the ISV in the upright position is higher than the veno-capillary pressure in the testicle, and hence could impair spermatogenesis prompting the need for treatment in varicoceles.Histoacryl transparent and Glubran2, the current commercially available adhesives for the treatment of varicoceles, do not differ with regard to efficiency, safety and tolerance during and after embolization. Both adhesives cause a mild pain in 30% of the patients in the week after embolization. The radiation exposure is low during embolizations of varicoceles with highly viscous liquid products. Therefore, the endovascular treatment with glue is an efficient, safe and tolerable method of treatment for varicoceles when applicable. Keywords: Varicocele; Embolization; Glue IntroductionThis thesis aimed at contributing to the pathophysiology and treatment of varicoceles. The research project encompasses five prospective studies and one retrospective study. The specific objectives of these clinical studies were to assess: (i) the safety, efficacy and tolerance of two types of glue and a non-gluing liquid embolic agent, in the endovascular treatment of varicoceles, (ii) to assess radiation burden for patient during varicocele embolization, (iii) to develop a standardized method to read the phlebographic anatomy of varicoceles and to test a different ontogenesis of varicoceles in adolescents and adults, and (iv) lastly to develop a standardized method to measure the intravascular pressure in the internal spermatic vein and to determine whether infertility in varicoceles can be explained by the principle of elevated hydrostatic pressure.

show abstract

Sclerosis and varicocele embolization with N-butyl cyanoacrylate: experience in 41 patients

Abstract: N2BCA as an embolic agent is a therapeutic alternative for the endovascular treatment of varicocele. This technique is uncomplicated, inexpensive, efficient, and safe.

Cited by 28 publications

References 17 publications

Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate

Comparison of three different embolic materials for varicocele embolization: retrospective study of tolerance, radiation and recurrence rate

Is Endoscopic Vasectomy Just a Dream: An ex vivo Study on Feasibility and Reliability of Endoluminal Occlusion of Porcine Vas Deferens

Contribution to the Pathophysiology and Treatment of Varicoceles

Contact Info

Product

Resources

About