Balloon-Assisted Embolization of Wide-Neck Aneurysms Using a Mixture of n -Butyl Cyanoacrylate, Lipiodol, and Ethanol in
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LABORATORY INVESTIGATION
EMBOLISATION (ARTERIAL)
Balloon-Assisted Embolization of Wide-Neck Aneurysms Using a Mixture of n-Butyl Cyanoacrylate, Lipiodol, and Ethanol in Swine: A Comparison of Four n-Butyl Cyanoacrylate Concentrations Mizuki Hama1 • Tetsuo Sonomura1 • Akira Ikoma1 • Masataka Koike1 • Atsufumi Kamisako1 Ryota Tanaka1 • Takao Koyama1 • Hirotatsu Sato1 • Fumihiro Tanaka1 • Shota Ueda1 • Ryuta Okuhira1 • Kenji Warigaya2 • Shinichi Murata2 • Motoki Nakai1
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Received: 30 January 2020 / Accepted: 20 June 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose To determine the optimal ratio of n-butyl cyanoacrylate (NBCA)–Lipiodol–ethanol (NLE) mixture for balloon-assisted embolization of wide-neck aneurysms. Materials and methods We created 32 wide-neck aneurysms on both the common carotid arteries and external iliac arteries in eight female swine. Eight aneurysms were randomly assigned to four groups. Under balloon occlusion, the aneurysms were packed using NLE at one of four ratios of NLE: 2:2:1 (NLE221; 40%NBCA); 3:6:1 (NLE361; 30%NBCA); 2:7:1 (NLE271; 20%NBCA); and 1:5:1 (NLE151; 14.3%NBCA). We performed angiography before and after embolization to assess the aneurysms, and we compared adhesion between NLE and the balloon and
assessed NLE migration. Three days after embolization, the aneurysms were removed for histopathologic evaluation. Results Embolization was performed in 27 aneurysms. Adhesion between NLE and the balloon was not observed in any group. NLE migration was found in 0/7 aneurysms in the NLE221 group, 0/6 in the NLE361 group, 5/6 in the NLE271 group, and 7/8 in the NLE151 group. NLE migration was significantly lower in the NLE221 group than in the NLE271 and NLE151 groups (P = 0.0047 and 0.0014, respectively) and was significantly lower in the NLE361 group than in the NLE271 and NLE151 groups (P = 0.0152 and 0.0047, respectively). Media necrosis of
& Tetsuo Sonomura [email protected]
Shota Ueda [email protected]
Mizuki Hama [email protected]
Ryuta Okuhira [email protected]
Akira Ikoma [email protected]
Kenji Warigaya [email protected]
Masataka Koike [email protected]
Shinichi Murata [email protected]
Atsufumi Kamisako [email protected]
Motoki Nakai [email protected]
Ryota Tanaka [email protected] Takao Koyama [email protected]
1
Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama 641-8510, Japan
2
Department of Human Pathology, Wakayama Medical University, Wakayama, Japan
Hirotatsu Sato [email protected] Fumihiro Tanaka [email protected]
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M. Hama et al.: Balloon-assisted embolization of wide-neck aneurysms using a mixture of…
the arterial wall close to the aneurysms was observed in all groups. Conclusion NLE with an NBCA concentration of C 30% is a safe and feasible embolic material for balloon-a
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