Basic Study of a Mixture of N -butyl Cyanoacrylate, Ethanol, and Lipiodol as a New Embolic Material

• Published in: Journal of vascular and interventional radiology Vol. 23; no. 11; pp. 1516 - 1521
• Main Authors: Kawai, Nobuyuki, MD, Sato, Morio, MD, Minamiguchi, Hiroki, MD, Ikoma, Akira, MD, Sanda, Hiroki, MD, Nakata, Kouhei, MD, Tanaka, Fumihiro, MD, Nakai, Motoki, MD, Sonomura, Tetsuo, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2012
• Subjects: Adhesiveness; Aneurysm - diagnostic imaging; Aneurysm - therapy; Animals; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - therapy; Disease Models, Animal; Embolization, Therapeutic - methods; Enbucrilate - administration & dosage; Enbucrilate - chemistry; Ethanol - administration & dosage; Ethanol - chemistry; Ethiodized Oil - administration & dosage; Ethiodized Oil - chemistry; Feasibility Studies; Female; Materials Testing; Particle Size; Polymerization; Radiography; Radiology; Rheology; Viscosity; NBCA, lipiodol, and ethanol mixture; NLE110; NLE112; NLE211; NLE111; NLE213; NLE312; NLE411; NLE113; NLE212; NLE311; NLE; NLE413; NLE313; NLE412; NLE at a ratio of 4:1:1; NLE at a ratio of 4:1:3; NLE at a ratio of 4:1:2; NBCA, lipiodol, and ethanol mixture at a ratio of 1:1:1; NLE at a ratio of 2:1:1; N-butyl cyanoacrylate; NLE at a ratio of 1:1:3; NLE at a ratio of 1:1:2; NLE at a ratio of 2:1:2; NLE at a ratio of 2:1:3; NBCA; NBCA mixed with lipiodol at a ratio of 1:1; NLE at a ratio of 3:1:3; NLE at a ratio of 3:1:2; NLE at a ratio of 3:1:1
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2012.08.017

Abstract Purpose To clarify the configuration change of N -butyl cyanoacrylate (NBCA) polymerization with increasing proportion of ethanol, the properties of a mixture of NBCA with lipiodol plus ethanol (NLE), and the feasibility of use of NLE for aneurysm packing in a swine model. Materials and Methods The polymerization configuration of NLE was explored using ratios of 1–4 parts NBCA and 1–3 parts ethanol per 1 part of lipiodol; a 1:1 ratio of NBCA to lipiodol (NLE110) was used as a control. The distance that NLE migrated into saline flowing in a tube was measured. A carotid artery aneurysm was created in each of 18 swine. Aneurysmal packing with three configurations—NLE110, NLE at a ratio of 1:1:2 (NLE112), and NLE at a ratio of 1:1:3 (NLE113)—was attempted in six swine for each configuration. Results Regardless of NBCA composition, medium-sized droplets, a single large droplet, and a noodle-shaped extrusion were observed in NLE with lipiodol versus ethanol ratios of 1:1, 1:2, and 1:3. NLE110 migrated as viscous fluid to 190 cm from the injection site, whereas NLE112 migrated for 81 cm±11 and NLE113 migrated for 74 cm±9. Instant outflow of NLE110 from the six aneurysms caused occlusion of the parent artery, with adhesion to the microcatheter. Packing was achieved with minimal adhesion for all six of the aneurysms packed with NLE112 or with NLE113. Conclusions With high ratios of ethanol, the NLE polymerization configuration acquired solid-like properties with potent occlusive ability and negligible adhesion to the microcatheter, suggesting its feasibility for packing of aneurysms.