泌尿生殖器領域のNBCAを用いた塞栓術

抄録

Embolization using N-butyl cyanoacrylate (NBCA) for genitourinary diseases shows immediate and secure occlusion of targeted lesions when NBCA is selected in the optimal situation and appropriately used with optimal concentration, injection speed, and devices. NBCA will show the best performance in embolization for massive bleeding with large arterial injury due to genital tract injury, cesarian section, and uterine/renal arteriovenous malformation (AVM) with high-flow arteriovenous shunt. In embolization of high flow AVMs, flow control with balloon occlusion of the feeding artery and/or drainage vein may be appropriately introduced to prevent migration of embolic material and to control the extent of embolic material. Embolization using NBCA for atonic bleeding is controversial because there is a risk of proximal embolization which may lead to continuous bleeding through collateral arteries, or uterine necrosis with low concentration NBCA. Embolization using NBCA in combination with a coil or vascular plug for urinary leakage is effective and minimally invasive. Long-lasting occlusion of the ureter with this technique is demonstrated in previous reports.