Transcatheter N-butyl Cyanoacrylate Embolization of Pseudoaneurysms

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition

“…In addition, other applications, including the use of NBCA to treat spinal vascular disease and during embolization for endoleaks that develop after endovascular aneurysm repair, have been described in recent studies [22,34,35,40,83,108,129,146,149,152,167].…”

“…In particular, NBCA is a useful embolic material in the following situations: (a) cases in which pseudoaneurysms cannot be embolized via selective catheterization using the isolation technique; (b) embolization involving the preservation of the parent artery [56,134,149,163,167,174,183]; (c) cases in which coil embolization might be unsuitable because of the condition of the target vessels, e.g., those involving markedly tortuous, stenotic, or fine vessels [54,72,87,135,138,165]; (d) cases involving patients in a hypocoagulable state (refer to CQ6). Furthermore, vascular embolization with NBCA has also been reported to be useful for nasal bleeding [103,104], hemoptysis [16,141], and gastrointestinal bleeding.…”

“…(4) Several injection techniques have been reported. The continuous column method, in which the NBCA is injected slowly but continuously to allow it to form a cast inside the lumen, is the most common method and allows controlled NBCA delivery, which prevents reflux [16,37,46,92,98,102,137,149]. In addition, intermittent injection with the aim of delivering drips of NBCA (the pumping method) and a method in which the NBCA in the catheter is pushed out with a bolus of dextrose (the sandwich technique) have also been reported [21,46,48,141].…”

“…In the thoracoabdominal field, embolic devices are often deployed in the distal portion of the target lesion to prevent the distal migration of NBCA [19,34,72,108,109,149,163], and NBCA is sometimes used in combination with other embolic materials in cases in which the target lesion was insufficiently embolized [72,77,81,87,134,162,180,182]. NBCA has also been occasionally used to fix the tips of indwelling catheters in place during hepatic arterial infusion chemotherapy [173,181].…”

Splenic artery embolization with Ankaferd blood stopper in a sheep model

“…It has to be used with caution due to technical problems with handling the material, and com- plications may occur in cases of nontarget embolization (22)(23)(24). Different from other embolizing agents, sclerosing agents lead to tissue necrosis.…”