Abstract
Purpose: N-butyl cyanoacrylate is a liquid embolic material used to treat bleeding. Rebleeding may occur after N-butyl cyanoacrylate embolization due to vasospasm and dilation of the embolized artery. However, the impact of vasospasm on N-butyl cyanoacrylate embolization has not been fully investigated. Therefore, we investigated the impact of vasospasm on the effects of N-butyl cyanoacrylate embolization in swine arteries.
Material and Methods: Using a swine bleeding model, 24 arteries (hepatic/splenic/both renal/cranial mesenteric) in 5 swine were divided into vasoactive and control groups. The recanalization rates after embolization with 20% N-butyl cyanoacrylate and the volume of N-butyl cyanoacrylate used for embolization were compared between the 2 groups. Arteries in the vasoactive group were constricted by constant venous infusion of vasopressin and an arterial injection of noradrenaline just before embolization and then dilated by arterial injection of papaverine and lidocaine immediately after embolization. Angiography was performed to evaluate recanalization of the embolized arteries immediately and at 5, 15, 30, 45, and 60 minutes after embolization. Recanalization was defined as complete recanalization within 60 minutes or partial recanalization at 60 minutes.
Results: Angiography revealed recanalization in a significantly greater proportion of arteries in the vasospasm group (11/12 arteries [91.7%]) than in the control group (2/12 arteries [16.7%]) (p = 0.0006). The median volume of N-butyl cyanoacrylate used during embolization was significantly lower in the vasoactive group (0.32 mL) than in the control group (0.78 mL) (p = 0.0037).
Conclusions: Vasospasm during N-butyl cyanoacrylate embolization increased the recanalization rate of the embolized arteries and reduced the embolization effect in swine.
