Abstract
Cyanoacrylates were first used for medical purposes during World War II to close skin wounds. Over time, medical applications were developed, specifically in the vascular field. Uses now range from extravascular instillation in vascular grafting to intravascular injection for embolization. These applications were made possible by the conduct of numerous preclinical studies involving a variety of tests and outcome measures, including angiographic and histological criteria. Cyanoacrylates were first harshly criticized by vascular surgeons, chiefly due to their fast and irreversible polymerization. Over the past five years, however, cyanoacrylates have earned an established place in endovascular interventional radiology. Given the irreversible effects of cyanoacrylates, studies in animal models are ethically acceptable only if supported by reliable preliminary data. Many animal studies of cyanoacrylates involved the experimental creation of aneurysms or arteriovenous fistulas, whose treatment by endovascular embolization was then assessed. In clinical practice, however, injection into non-modified arteries may be desirable, for instance, to deprive a tumor of its vascular supply. To help investigators in this field select the animal models and procedures that are most appropriate for their objectives, we have reviewed all published in vivo animal studies that involved the injection of cyanoacrylates into non-modified arteries to discuss their main characteristics and endpoints.
Highlights
Introduction iationsN-butyl cyanoacrylate (NBCA) is generating considerable interest among interventional radiologists given its good efficacy and biological tolerance when used for endovascular embolization
After the initial screening of the titles and abstracts, we excluded 141 papers, most of which dealt with the NBCA embolization of experimentally produced arteriovenous malformations (AVMs) or aneurysms
We aimed to provide an exhaustive review of the preclinical animal experiments that used cyanoacrylates for endovascular interventions on non-modified arteries
Summary
N-butyl cyanoacrylate (NBCA) is generating considerable interest among interventional radiologists given its good efficacy and biological tolerance when used for endovascular embolization. Practices regarding the clinical uses of NBCAs vary across countries. Glubran® 2 (GEM, Viareggio, Italy) has obtained the European Conformity (EC) mark, whereas Trufill® (Cordis, Miami Lakes, FL, USA) has been approved by the. Food and Drug Administration in the US but is not available elsewhere. Histoacryl® is an NBCA and is available in the USA and Japan but is normally “off-label” in Europe for endovascular purposes in humans, it has been used for a long time. Bucrylate® , or isobutyl 2-cyanoacrylate (IBCA), was used in early studies before it was demonstrated that NBCA had a better safety profile and greater tensile strength. General agreement exists about the usefulness, when performing intra-arterial injections of cyanoacrylates, Licensee MDPI, Basel, Switzerland
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