Case Series of Four Patients undergoing Treatment for Glue Migration during Embolization using N-Butyl-Cyanoacrylate

Abstract

  Glue migration is a potential complication of endovascular surgery performed using n-butyl-cyanoacrylate (NBCA). Herein, we report the management of four cases with NBCA glue migration encountered at our institution. NBCA glue migration involved tumor embolization in three cases : glue migration was observed at the internal carotid artery in two cases and anterior cerebral artery in one case. The migrated glues were successfully retrieved in these cases using stent retrievers (SRs). The remaining case involved glue migration during arteriovenous malformation embolization. The glue migrated into the vertebral and posterior cerebral arteries. In this case, a stent was deployed at each site after administrating antiplatelet therapy. Our findings suggest that NBCA embolectomy using a SR is useful for managing glue migration. Furthermore, in cases where the NBCA glue needs to be compressed against the vessel wall, antiplatelet therapy followed by stenting can be used, depending on the subsequent treatment plan.