Abstract
Endovascular embolization agents are particles and fluids that can be released into the bloodstream through a catheter to mechanically and/or biologically occlude a target vessel, either temporarily or permanently. Vascular embolization agents are available as solids, liquids, and suspensions. Although liquid adhesives (glues) have been used as embolic agents for decades, experience with them for peripheral applications is generally limited. Cyanoacrylates are the main liquid adhesives used for endovascular interventions and have a major role in managing vascular abnormalities, bleeding, and many vascular diseases. They can only be injected as a mixture with ethiodized oil, which provides radiopacity and modulates the polymerization rate. This review describes the characteristics, properties, mechanisms of action, modalities of use, and indications of the cyanoacrylate-Lipiodol® combination for peripheral embolization.
Highlights
Accepted: 20 September 2021Embolic agents can be classified by their physical and biological properties, which affect the level of occlusion and tissue response
Evidence exists that portal vein embolization with NBCA generates faster and greater liver regeneration compared with standard Polyvinyl alcohol (PVA) particles and coils, allowing for earlier hepatectomy [35,36,37,38]
The glue injection begins in the distal intrapelvic segment of the gonadal vein, and the catheter is withdrawn slowly while injecting NBCA under fluoroscopic control
Summary
Embolic agents can be classified by their physical and biological properties, which affect the level of occlusion and tissue response. Specific characteristics of cyanoacrylates confer high suitability to the management of a wide variety of vascular conditions affecting the peripheral circulation. These characteristics include high radiopacity when mixed with ethiodized oil (Lipiodol® Ultra Fluid, Guerbet, Villepinte, France), rapid embolization, a low rate of same-vessel recanalization, and the capacity to penetrate the vascular bed in a flow-directed fashion. This review discusses the properties, mechanisms of action, techniques of use, main indications, and potential pitfalls of endovascular cyanoacrylate-glue embolization at peripheral sites. Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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