| Autor: |
Guillen K; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France.; ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France., Comby PO; ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France., Oudot A; Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France., Salsac AV; Biomechanics and Bioengineering Laboratory, UMR CNRS 7338, Technology University of Compiègne, 60203 Compiègne, France., Falvo N; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France.; ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France., Virely T; Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France., Poupardin O; Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France., Guillemin M; Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France., Chevallier O; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France.; ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France., Loffroy R; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France.; ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France. |
| Abstrakt: |
N-butyl cyanoacrylate (NBCA) is a lipophilic, permanent embolic glue that must be opacified for fluoroscopic guidance. Empirically, lipophilic Lipiodol Ultra Fluid ® (LUF) has been added to produce a single-phase physically stable mixture. Varying the dilution ratio allows control of glue polymerization kinetics. LUF is far more costly than water-soluble iodinated contrast agents (ICAs). Our purpose was to evaluate whether a water-soluble nonionic iso-osmolar ICA could be used instead. We embolized both renal arteries of six swine using 1:3 NBCA-LUF or NBCA-iodixanol in 1:1, 1:3, and 1:7 ratios. We used both micro-computed tomography to assess the distality of glue penetration and indexed cast ratio and histology to assess distality, arterial obliteration, vessel-wall damage, and renal-parenchyma necrosis. Glue-LUF produced significantly greater indexed cast ratio and renal-artery ROI values and a significantly shorter cast-to-capsule distance. The injected volume was significantly greater with 1:7 iodixanol than with the other mixtures. No significant differences were found for histological evidence of artery obliteration, vessel-wall damage, or renal-parenchyma necrosis. This is the first study dealing with ICA alone as a contrast agent for cyanoacrylate embolization, compared to LUF. More research is needed to determine whether water-soluble nonionic iodinated agents can be used for human NBCA embolization given the good safety profile, availability, and low cost of ICA. |
