Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis

Ali, Adnan Al; Ahle, Margareta; Björnsson, Bergþór; Sandström, Per

doi:10.1007/s00330-020-07685-w

Cited by 24 publications

(7 citation statements)

References 83 publications

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“…It has been found that a combination of coils/vascular plugs and particles yields increased FLR growth compared to particles alone [5]. Several studies have indicated a benefit of using NBCA over particles [6][7][8] and this was recently confirmed in a randomized controlled trial including 60 patients [9]. Furthermore, a technique has been described where vascular plugs are combined with NBCA embolization to avoid non-target embolization of the FLR and reduce the re-canalization rate [7,10], but there is no study demonstrating the actual benefit of this technique compared to embolization with NBCA alone.…”

Section: Introductionmentioning

confidence: 99%

Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?

Carling

Røsok

Berger

et al. 2021

Cardiovasc Intervent Radiol

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Purpose To examine if the addition of a central vascular plug (CVP) to portal vein embolization (PVE) with N-butyl cyanoacrylate-glue (NBCA) increases future liver remnant (FLR) growth. Material and Methods This is a single-center retrospective study of 115 consecutive patients with colorectal liver metastases undergoing PVE in 2013–2019. All patients were embolized with NBCA as the main embolic agent. In 2017–2019 NBCA was combined with a CVP in the central part of the right portal vein. Growth of the FLR and standardized FLR (sFLR) including degree of hypertrophy (DH) and kinetic growth rate (KGR) were analyzed, as well as procedure data such as use of cone-beam CT (CBCT), dose area product (DAP), fluoroscopy time and contrast dose. Results A total of 40 patients (35%) underwent PVE with a combination of CVP and NBCA. The DH was higher in these patients after 4 weeks, mean 13.6% (SD 7.8) vs. 10.5% (SD 6.4; p = 0.022), verified in multivariate analysis (coefficient 4.1, p = 0.015). A CVP did not significantly increase the resection rate (90% vs 82%, p = 0.4). Cone beam CT was used in 65 patients (57%). Use of CBCT did not affect FLR growth, and fluoroscopy time and contrast doses were not different in patients having a CBCT or not. Slightly lower DAP (median 3375 vs. 4499 cGy*cm2; p = 0.09) was seen in procedures where CBCT was used. Conclusion A CVP in addition to NBCA embolization was associated with increased growth of the FLR compared to NBCA alone.

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Section: Introductionmentioning

confidence: 99%

Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?

Carling

Røsok

Berger

et al. 2021

Cardiovasc Intervent Radiol

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“…Histoacryl (n-Butyl-2-Cyanoacrylate) is a regulatory-approved tissue adhesive. It is considered the best choice for portal vein embolism [ 9 ]. Lipiodol (ethiodized oil) is a radio-opaque contrast agent that is used widely in radiological investigation.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Management of Coronary Artery Perforation During Percutaneous Coronary Intervention Using Injection of Combined Histoacryl (n-Butyl-2-Cyanoacrylate) and Lipiodol (Ethiodized Oil)

et al. 2023

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Case series Patients: Male, 51-year-old • Male, 72-year-old Final Diagnosis: Coronary disease Symptoms: Chest pain Clinical Procedure: — Specialty: Cardiology Objective: Unusual clinical course Background: Coronary artery perforation is a rare complication of percutaneous coronary intervention for coronary artery occlusion. This report is of 2 cases of coronary artery perforation during percutaneous coronary intervention that were managed successfully using injection of combined Histoacryl (n-Butyl-2-Cyanoacrylate) and Lipiodol (ethiodized oil). Case Reports: Case 1 was a 51-year-old man with a past medical history of hypertension, dyslipidemia, and multivessel coronary disease. He was admitted to our hospital with inferior wall myocardial infarction, and a stent was placed in the proximal right coronary artery. He also had chronic total occlusion (CTO) of the left anterior descending artery (LAD). The planned LAD CTO intervention was complicated by balloon-induced coronary perforation and was managed successfully with intracoronary injection of Histoacryl-Lipiodol mixtures via microcatheter. He was discharged in stable condition without any serious consequences. Case 2 was a 72-year-old man with underlying hypertension who was admitted to the hospital with diagnosis of unstable angina. The diagnostic angiography showed occlusion of the LAD, CTO of the left circumflex artery, and minor atherosclerosis in right coronary artery. A stent was placed in the mid-LAD without any complications. Subsequently, a planned left circumflex artery CTO intervention was complicated by wire-induced coronary perforation, which was treated successfully with injection of Histoacryl-Lipiodol mixture. The patient was discharged in good condition. Conclusions: Histoacryl and Lipiodol injection was a rapid and effective management method in 2 rare cases of coronary artery perforation during percutaneous coronary intervention.

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“… 130 reported that PVE with ethanol significantly increased the non-embolised liver volume compared to NBCA, but a recent systematic review concluded that NBCA provided greater FLR hypertrophy, with no difference in the rate of complications. 131 A recent RCT showed that PVE with NCBA plus iodised oil resulted in faster and greater FLR hypertrophy than PVE with PVA particles plus coils (57% vs. 37% respectively, at 28 days, p < 0.001). 132 However, this was not associated with a significantly higher rate of surgical resection (80% vs. 77%, respectively, p = 0.75) or a statistically significant better postoperative outcome (liver failure in 13% vs. 27%, respectively, p = 0.27).…”

Section: Portal Vein Embolisationmentioning

confidence: 97%

Imaging-guided interventions modulating portal venous flow: Evidence and controversies

et al. 2022

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Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis

Cited by 24 publications

References 83 publications

Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?

Portal Vein Embolization Using N-Butyl Cyanoacrylate-Glue: What Impact Does a Central Vascular Plug Have?

Two Cases of Management of Coronary Artery Perforation During Percutaneous Coronary Intervention Using Injection of Combined Histoacryl (n-Butyl-2-Cyanoacrylate) and Lipiodol (Ethiodized Oil)

Imaging-guided interventions modulating portal venous flow: Evidence and controversies

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