In Vivo Animal Study of a Highly Viscous N-butyl Cyanoacrylate Medical Adhesive for Intravenous Embolization.

Jae-Won Seo,Young Gook Koh,Habeen Park,Seoyun Lee,Jang Yong Kim,Insoo Park,Wonmok Lee,Dogeun Kim

doi:10.3390/ma14133527

Jae-Won Seo, Young Gook Koh + Show 6 more

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https://doi.org/10.3390/ma14133527

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Abstract

N-butyl cyanoacrylate (NBCA) is a liquid monomer that undergoes an exothermic polymerization reaction to form a solid upon initiation with hydroxyl anions. Recently, EGpresto, a highly viscous NBCA-based adhesive, has been developed for vascular-occlusion purposes. In this study, we investigated the heat of polymerization of EGpresto and compared the results with those of a low-viscosity NBCA glue. Results show that EGpresto exhibited a lower heat of polymerization (64 ± 7 °C vs. 34 ± 1 °C). This was due to its high viscosity, which resulted in a delayed polymerization time. To investigate the efficacy and safety of EGpresto for intravenous embolization, a 14 d in vivo animal test was conducted using three pigs. Five cc of EGpresto was injected into the epigastric vein of each animal. Complete postoperative vein occlusion was confirmed at 7 and 14 d by ultrasonographic visualization. After the animals were sacrificed, the operated and unoperated veins were exposed, and the injected adhesive was found without migration. During the histology, the injected adhesive was not found in the inner or outer vein walls, and the immune reactions seemed to be the only foreign-body reaction, showing that EGpresto is a non-toxic and safe intravascular embolic agent.

Highlights

The clinical use of N-butyl cyanoacrylate (NBCA)-based medical adhesives has been rapidly increasing in recent years, for use as embolic agents for endovascular treatments such as transcatheter arterial embolization [1,2,3], arteriovenous malformations [4,5,6,7], and venous occlusion [8,9,10]
It was clear that the heat of polymerization for the highly viscous NBCA glue decreased to 53% of the value of a low-viscosity NBCA
We investigated the physical properties of EGpresto, a new NBCA-based adhesive recently developed for venous embolization

Summary

Introduction

NBCA is a liquid acrylic monomer, and its polymerization reaction can be initiated in an aqueous environment. Because it is rapidly cured into a solid form under intervascular conditions, NBCA adhesive is an appropriate choice for immediate occlusion of the artery and vein [11]. The other disadvantage of NBCA is its high heat of polymerization [15], which often results in a local temperature increase of over 70 ◦ C during application This type of heat generation can result in critical side effects such as thermal burns at the treatment site [16]

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