Transcatheter embolization of visceral artery aneurysms using n-butyl cyanoacrylate

PurposeTo clarify the efficacy of transcatheter embolization using n-butyl cyanoacrylate (NBCA) glue for visceral artery aneurysms.Materials and MethodsFor 32 aneurysms (7 splenic, 7 internal iliac, 5 hepatic arteries, 1 celiac, others) in 29 patients, embolization using NBCA with Lipiodol (33-67%) was performed. The etiology includes atherosclerosis in 12, pseudoaneurysm in 10, myocosis in 3, and median arcuate ligament compression in 2, hypersplenism in 5. In 22 aneurysms, coils were used as a frame or a nest for subsequent glue injection and in 5 aneurysms only glue was used without any coil. Flow control using a balloon catheter was applied in 14 aneurysms and distal neck was embolized by coils in 10 aneurysms to prevent glue migration. The coil and glue packing densities for the aneurysmal volumes were calculated.ResultsFor 11.6±22.3 (mean±SD) mL of aneurysm volumes, 1.8±1.8mL of NBCA (40.8±11.0%) was injected after framing by 0.16±0.24mL of coil volumes; the coil packing density was only 3.4±5.9%. In 2 splenic aneurysms, glue was migrated to the splenic parenchyma intentionally as partial splenic embolization. In other two internal iliac artery aneurysms, minor distal migration was observed without any clinical sequela. Incomplete occlusion occurred in one aneurysm due to the shortness of glue (success rate 94.4%) and recurrence occurred in two mycotic aneurysms (11.1%) lately. NBCA expanded 6.4±8.0 times in the aneurysms.ConclusionTranscatheter embolization of visceral artery aneurysms using NBCA was useful in reducing coil usage with a high success rate. PurposeTo clarify the efficacy of transcatheter embolization using n-butyl cyanoacrylate (NBCA) glue for visceral artery aneurysms. To clarify the efficacy of transcatheter embolization using n-butyl cyanoacrylate (NBCA) glue for visceral artery aneurysms. Materials and MethodsFor 32 aneurysms (7 splenic, 7 internal iliac, 5 hepatic arteries, 1 celiac, others) in 29 patients, embolization using NBCA with Lipiodol (33-67%) was performed. The etiology includes atherosclerosis in 12, pseudoaneurysm in 10, myocosis in 3, and median arcuate ligament compression in 2, hypersplenism in 5. In 22 aneurysms, coils were used as a frame or a nest for subsequent glue injection and in 5 aneurysms only glue was used without any coil. Flow control using a balloon catheter was applied in 14 aneurysms and distal neck was embolized by coils in 10 aneurysms to prevent glue migration. The coil and glue packing densities for the aneurysmal volumes were calculated. For 32 aneurysms (7 splenic, 7 internal iliac, 5 hepatic arteries, 1 celiac, others) in 29 patients, embolization using NBCA with Lipiodol (33-67%) was performed. The etiology includes atherosclerosis in 12, pseudoaneurysm in 10, myocosis in 3, and median arcuate ligament compression in 2, hypersplenism in 5. In 22 aneurysms, coils were used as a frame or a nest for subsequent glue injection and in 5 aneurysms only glue was used without any coil. Flow control using a balloon catheter was applied in 14 aneurysms and distal neck was embolized by coils in 10 aneurysms to prevent glue migration. The coil and glue packing densities for the aneurysmal volumes were calculated. ResultsFor 11.6±22.3 (mean±SD) mL of aneurysm volumes, 1.8±1.8mL of NBCA (40.8±11.0%) was injected after framing by 0.16±0.24mL of coil volumes; the coil packing density was only 3.4±5.9%. In 2 splenic aneurysms, glue was migrated to the splenic parenchyma intentionally as partial splenic embolization. In other two internal iliac artery aneurysms, minor distal migration was observed without any clinical sequela. Incomplete occlusion occurred in one aneurysm due to the shortness of glue (success rate 94.4%) and recurrence occurred in two mycotic aneurysms (11.1%) lately. NBCA expanded 6.4±8.0 times in the aneurysms. For 11.6±22.3 (mean±SD) mL of aneurysm volumes, 1.8±1.8mL of NBCA (40.8±11.0%) was injected after framing by 0.16±0.24mL of coil volumes; the coil packing density was only 3.4±5.9%. In 2 splenic aneurysms, glue was migrated to the splenic parenchyma intentionally as partial splenic embolization. In other two internal iliac artery aneurysms, minor distal migration was observed without any clinical sequela. Incomplete occlusion occurred in one aneurysm due to the shortness of glue (success rate 94.4%) and recurrence occurred in two mycotic aneurysms (11.1%) lately. NBCA expanded 6.4±8.0 times in the aneurysms. ConclusionTranscatheter embolization of visceral artery aneurysms using NBCA was useful in reducing coil usage with a high success rate. Transcatheter embolization of visceral artery aneurysms using NBCA was useful in reducing coil usage with a high success rate.