Modification of cyanoacrylate for therapeutic embolization: preliminary experience

Cromwell, Laurence D.; Kerber, CW

doi:10.2214/ajr.132.5.799

Cited by 99 publications

(31 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most cases of direct type CCF are caused by trauma and cases of indirect type usually are related to pregnancy, paranasal sinusitis, trauma, surgical procedure, or cavernous sinus thrombosis or are idiopathic. 10 The standard diagnostic tool is cerebral angiography. However, many therapeutic methods for CCF have been used, including surgery, embolization, direct compression of the supplied vessels (CCA), conventional radiotherapy, and GKRS.…”

Section: Discussionmentioning

confidence: 99%

Verifying complete obliteration of carotid artery-cavernous sinus fistula: role of color Doppler ultrasonography.

Chiou

Chou

Guo

et al. 1998

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

The purpose of this study was to evaluate the role of color Doppler ultrasonography in verifying obliteration of carotid artery‐cavernous sinus fistula before and after therapeutic embolization or gamma knife radiosurgery. Before treatment, carotid artery‐cavernous sinus fistula showed the following data on color Doppler ultrasonography: (1) increased blood flow in the common carotid artery (220 to 1264 ml/min with mean+/‐SD of 728+/‐378 ml/min); internal carotid artery (435 to 1097 ml/min with mean+/‐SD of 834+/‐216 ml/min) in fistulas of the direct type; and external carotid artery (85 to 257 ml/min with mean+/‐SD of 170+/‐75 ml/min) in fistulas of the indirect type in comparison to the contralateral side; (2) reverse pulsatile flow or spiculated wave form with turbulent flow in the engorged superior ophthalmic vein on the lesion side in all patients. All of the above abnormal hemodynamic changes became normal in six patients immediately after first embolization, in two patients with balloon embolization combined with subsequent direct embolization by direct puncture through the superior orbital fissure or internal carotid artery embolization, and in five patients after gamma knife radiosurgery at 4, 4, 8, 9, and 9 months, respectively. Color Doppler ultrasonography might be a good modality in long‐term follow‐up of carotid artery‐cavernous sinus fistula after gamma knife radiosurgery and embolization.

show abstract

Section: Discussionmentioning

confidence: 99%

Verifying complete obliteration of carotid artery-cavernous sinus fistula: role of color Doppler ultrasonography.

Chiou

Chou

Guo

et al. 1998

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

show abstract

“…The embolization mixture was Histoacryl mixed with the iodized oil Lipiodol Ultra-fluid (BykGulden, Constance) in equal amounts (1:1). The occlusion mechanism was polymerization in contact with anions [12,14,25,31], Ethibloc (Ethicon, Hamburg). This is available in sterilized 7.5-ml syringes containing an alcoholic solution (60%) of 210mg/ml zein (com protein-occluding agent), 162mg/ml sodium amido-trizoate (contrast medium), 145 mg/ml oleum papaveris (prevents file formation) and 6 mg/ml propylene glycol (désinfectant).…”

Section: Embolization Mediamentioning

confidence: 99%

“…Since the polymerization of Histoaryl is catalyzed by anions, preinjection of 40% glucose is needed to delay polymerization time and to guarantee catheter passage [14,25,45]. If mixed with the unpolar Lipiodol (1:1), polymerization time is prolonged 10-fold and the mix ture remains stable [12,45]. Even traces of anions lead to irreversible polymerization and catheter occlusion.…”

Section: Laboratory Experimentsmentioning

confidence: 99%

Experimental Basis of Angioinfarction for the Treatment of Renal Hypertension

Rassweiler¹,

Kauffmann

Richter

et al. 1986

Urol Int

View full text Add to dashboard Cite

Collateral circulation and recanalization represent the main problems of organ-ablating renal embolization. Different animal models were used to study the influence of central, peripheral, and capillary occlusion on organ necrosis. The first laboratory experiments were performed to optimize transcatheteral application of the embolization media tested (Gelfoam powder, Histoacryl, Ethibloc). Experiments with the model of a normal rat kidney (n = 400) showed that only capillary embolization homogenously occluding the entire arterial system resulted in complete organ necrosis, while following central (renal artery ligation) or peripheral (Gelfoam powder) occlusion, areas of intact parenchyma remained. Ethibloc/glucose proved to be the embolization medium best suited for capillary embolization (radiopaque, inert, slow resorption). Studies with the model of unilateral renal hypertension of the rat (n = 146) demonstrated the equivalent therapeutic efficiency on blood pressure of Ethibloc embolization (57% cured, 21% improved) compared to surgical nephrectomy (50% cured, 29% improved), whereas renal artery ligation (85% failed) resulted in minor improvement only. In order to adapt capillary embolization with Ethibloc/glucose to clinical angiographic techniques, we performed angioinfarction of canine kidneys (n = 15): the use of a balloon catheter is mandatory. This guarantees blood stasis during the embolization procedure and avoids embolic reflux. Possible clinical indications of capillary embolization in renal hypertension as a less invasive method are, e.g.: malignant nephrosclerosis; renovascular or glomerulonephritic contracted kidneys, and renal dysplasia. Indications for super-selective vaso-occlusion are renal aneurysms, a-v malformations, and segmental hypoplasia.

show abstract

“…Embolization material was not seen to enter the venous systems, even in the presence of large arterio venous shunts. But it was also not expected because of the rapid polymerization of the acrylates [2], If an operation has to be performed and superselective catheterization is The effectiveness of radiotherapy in case of a renal cell carcinoma is controversial [13]. 2 of the presented pa tients were additionally treated in this way so that no possible therapy was omitted.…”

Section: Complications After Embolizationmentioning

confidence: 99%

“…Considering the relatively high frequency of bone métastasés and such serious consequences as pain, restriction of mobility and confinement to bed, active therapy is necessary, although the prognosis is poor. The therapeutic possibilities con sist in: (1) removing the metastatic foci and replacing them by bone cement, plastic implants, endoprotheses or arthrodeses; (2) embolizing the vessels feeding the bone tumor, and (3) radiotherapy (controversial) [9,13].After surgical removal of the primary tumor, further treatment for skeletal métastasés should be considered [8,12], Embolization as the only therapy should be carried out in the following cases: (1) the foci are so extensive that complete removal is impossible; (2) the patient is still in a satisfactory state of health, and (3) other métas tasés have not yet been found.Embolization is of special interest when the osteolyses of the pelvic girdle cause loss of stability, and subsequent Methods Cyano-acrylate, which was diluted with Lipiodol (Byk Gulden) in a ratio between 1:1 and 1:6, was used for distal and permanent embolization; the material can be rendered more radiopaque by add ing a small amount of tantalum powder [2,7].As acrylate does not polymerize in a non-ionized medium, the blood has to be totally washed out of the catheter (no coaxial system); this is done with 40% dextrose [5]. The recommended dose of the acrylate mixture should not exceed 0.5-1.0 ml.…”

mentioning

confidence: 99%