Feasibility and Safety of n-Butyl Cyanoacrylate–Lipiodol–Iopamidol as an Alternative Liquid Embolic Material

• Published in: Cardiovascular and interventional radiology Vol. 44; no. 3; pp. 482 - 488
• Main Authors: Higashino, Nobuyuki, Sonomura, Tetsuo, Fukuda, Kodai, Ikoma, Akira, Okuhira, Ryuta, Ueda, Shota, Kawai, Nobuyuki
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2021; Springer Nature B.V
• Subjects: Adhesion; Aneurysm; Aneurysms; Angiography; Arteries; Balloon treatment; Cardiology; Configurations; Cyanoacrylates; EMBOLISATION (arterial); Embolization; Evaluation; Imaging; In vitro methods and tests; Laboratory Investigation; Livestock; Medical equipment; Medicine; Medicine & Public Health; Nuclear Medicine; Occlusion; Radiology; Swine; Ultrasound; Balloon-assisted packing; Iopamidol; Embolization; Lipiodol; Butyl cyanoacrylate; Aneurysm; n-Butyl cyanoacrylate
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-020-02681-5

Purpose To evaluate the feasibility and safety of n -butyl cyanoacrylate (NBCA)–Lipiodol–Iopamidol (NLI) as a liquid embolic material. Materials and Methods In vitro, the ratio of NLI components was adjusted and the configuration of the mixtures was assessed visually in saline. In vivo, 14 wide-necked aneurysms were created on the common carotid and external iliac arteries of four female swine. Under balloon occlusion, 12 aneurysms were embolized with NLI prepared at a NBCA–Lipidol–Iopamidol ratio of 2:3:1 (NLI231), and two were embolized with NBCA–Lipiodol (NL) prepared at a NBCA–Lipiodol ratio of 1:2 (NL12) as a trial group. We performed angiography to evaluate the effectiveness of embolization and adhesion of the embolic material to the balloons or microcatheters. Results In vitro, NLI231 (33% NBCA) was considered to be the optimal ratio for aneurysm embolization based on its configuration and stability. In vivo, embolization using NLI231 was successful and no adhesion between the embolic material and the balloons or microcatheters was observed in all 12 aneurysms. Embolization with NL12 was impossible in the other two aneurysms due to leakage and adhesion of NL. Conclusion The configuration of NLI changed at each ratio. NLI231 is a feasible and safe liquid embolic material for balloon-assisted embolization of wide-necked aneurysms in swine.