Transcatheter N-butyl Cyanoacrylate Embolization of Pseudoaneurysms

Abstract

To report clinical experience with N-butyl cyanoacrylate (NBCA) for embolization of pseudoaneurysms at various locations. Retrospective study of patients with pseudoaneurysms treated with NBCA over a 4-year period was conducted. Seventeen consecutive patients were evaluated, including three women and 14 men ranging in age from 25 to 77 years (mean, 60.6 y). NBCA was the only embolic agent used in 15 patients; in two patients, a liquid coil and a microcoil were placed before administration of NBCA. NBCA was mixed with iodized oil in a 1:3 ratio to control its polymerization time and to make it radiopaque. Diagnostic angiography and embolization were performed at the same session. Embolized sites included gastrointestinal tract (n = 6), spleen (n = 5), liver (n = 2), kidney (n = 1), chest (n = 1), oral cavity (n = 1), and buttock (n = 1). NBCA embolization was successful in 16 of 17 patients (94%), with complete occlusion of pseudoaneurysms. In one patient with a gastroduodenal artery stump pseudoaneurysm, NBCA embolization failed, and a stent-graft (8 mm/40 mm) was placed in the hepatic artery, excluding the pseudoaneurysm and preserving the hepatic artery. No major complications occurred, and there were no recurrences of pseudoaneurysms. NBCA embolization was an effective method for the treatment of pseudoaneurysms.