Cyanoacrylate Research Articles

Performance analysis of cyanoacrylate bonded optical fiber 2 × 2 acoustic couplers for sensing applications

In this paper the behavior of a cyanoacrylate (CA) bonded optical fiber acoustic signal coupler will be studied in detail. A stainless-steel mold was used to create a 2×2 CA coupler that transfers guided waves between two optical fibers. Four FBGs placed at each port were used to assess the repeatability, signal behavior, and performance of the coupler produced. Signal propagation through the network was mapped to determine how the initial acoustic signal traveled and subdivided through the fiber network. To examine the repeatability of the signal coupler interaction, the experiments were performed multiple times. Finally, the acoustic energy transferred through the coupler’s paths was calculated to assess the performance of the 2×2 coupler. The coupler successfully and repeatably transferred an acoustic signal from one optical fiber to another; however, the performance associated with the current coupler design was limited by relatively large excess and return losses. Improvements to the CA coupler design are then proposed from the results.

Transcatheter arterial embolization of nonvariceal gastrointestinal bleeding with n-butyl cyanoacrylate or coils: a systematic review and meta-analysis

This report is of a systematic review and meta-analysis evaluating the efficacy and safety of transcatheter arterial embolization (TAE) for nonvariceal gastrointestinal bleeding (GIB) with n-butyl cyanoacrylate (NBCA) or coils as the primary embolic agent. The primary outcome was the clinical success rate. The secondary outcomes were technical success rates, 30-day rebleeding rates, major complication rates, and 30-day overall mortality rates. A systematic search was performed in PubMed, Embase, and Cochrane Library. Articles included had been published in English from January 2000 to August 2023 and assessed patients with nonvariceal upper and lower GIB (UGIB and LGIB) who received TAE with NBCA or coils. Single-arm meta-analyses were performed for these outcomes. Subgroup analyses comparing NBCA and coils were conducted if there were more than 10 articles selected for each outcome. Thirty-seven articles were selected for analysis. The pooled rates of TAE for UGIB and LGIB were clinical success 73.0% and 76.5%, technical success 94.9% and 91.4%, 30-day rebleeding 25.0% and 17.1%, major complications 3.5% and 10.0%, and 30-day overall mortality 20.7% and 11.4%, respectively. The subgroup analysis showed a significant difference only for the technical success rates of LGIB between NBCA and the coils (p < 0.001). The systematic review and meta-analysis indicate that TAE with NBCA or coils as the primary embolic agent is safe and effective for both UGIB and LGIB.

Multiple delayed-onset metachronous ileal stenoses after transcatheter arterial embolization using N-butyl-2-cyanoacrylate for upper gastrointestinal bleeding: factors of complication and importance of plain CT evaluations

Abstract A 63-year-old man underwent transcatheter arterial embolization (TAE) using a mixture of N-butyl-2-cyanoacrylate (NBCA) and iodized oil to treat acute gastrointestinal (GI) bleeding. The procedure was initially successful; however, the patient developed ileus &amp;gt;1 month later and subsequently underwent several surgeries to treat the multiple metachronous ileal stenoses. The flux of a small amount of off-target glue was the primary cause of these complications. As the patient had few symptoms in the first month post-TAE, however, affirming the diagnosis took time. A detailed review of plain CT scans was a decisive factor in achieving the final diagnosis. This case demonstrates that TAE using an NBCA–iodized oil mixture effectively treats acute GI bleeding. However, a complication such as off-target embolization is likelier to occur because of a combination of certain factors such as vascular anatomy, complexity of the procedure, and NBCA dilution. Close observation using plain CT should be performed for the identification of off-target embolization occurrence even in cases of successful TAE.

Clinical Application of n-Butyl-2- Cyanoacrylate (NBCA) in the Transarterial Embolization for Type I/II Endoleak During and After EVAR Surgery

Exploring the effectiveness and safety of n-butyl-2-cyanoacrylate (NBCA) in the transarterial embolization for common endoleak during and after endovascular repair of aortic aneurysm (EVAR). A total of 226 patients with abdominal aortic aneurysm (AAA) were treated with EVAR in 4 years August 2019 to February 2023, including 46 patients with ruptured aneurysms (rAAA). Account 37 cases developed endoleak during EVAR surgery and follow-up period, 28 non-ruptured AAA patients and 9 rAAA patients, then treated with NBCA for transarterial embolization. Follow up for at least six months to observe its clinical efficacy and adverse reactions. Among 37 cases of endoleak, there were eight cases of primary type Ia endoleak and one cases of primary right type Ib endoleak in the rAAA group, one case of primary type Ib endoleak, two cases of secondary type Ia endoleak and 25 cases of Postoperative type II endoleak in the non-ruptured AAA group. Three patients with primary type Ia endoleak were treated with coil assisted NBCA in the rAAA group, while the remaining 34 patients with type I and type II endoleaks were treated with NBCA alone. All transarterial embolization achieved technical success and the endoleak disappeared. Postoperative hospitalization observation showed that three cases patients in the rAAA group who experienced primary type Ia endoleak during emergency EVAR surgery died within 4 days after surgery due to hemorrhagic shock and multiple organ failure. Two patients experienced non-AAA related deaths during the follow-up period. Transartrial embolization with NBCA for the treatment of primary and secondary endoleak is a safe and effective method. It can achieve more dense embolization of the aneurysm sac and more complex endoleaks embolization. And it showed a low recurrence rate of endoleak and the incidence of perioperative complications after surgery, which is worthy of clinical promotion and application. Even in emergency EVAR combined with primary type I endoleak treatment in rAAA patients, patients can still benefit.

Mesenteric Vein to Gonadal Vein Shunt Embolization in Patients with Portal Hypertension: Technical Considerations and Clinical Outcomes.

To assess the technical and clinical outcomes of percutaneous embolization for high-flow mesenteric vein to gonadal vein (MGV) portosystemic shunts. In this HIPPA-compliant, review board-approved study, patients who underwent embolization of MGV shunts between 2011 and 2023 were included. Patient demographic data, embolization technique, clinical outcomes, and complications were retrieved from the electronic health records. Technical success was defined as complete occlusion of the shunt on follow-up imaging. Clinical outcomes assessed were resolution/improvement of hepatic encephalopathy, improvement in liver function, changes to liver volumes, and occurrence of adverse events. Eight patients (mean age 59.5, 75% female) with nine MGV shunts were included. The indications for shunt embolization included medically refractory hepatic encephalopathy, bleeding duodenal varices, and transplant liver dysfunction. The mean maximum shunt diameter was 23.3mm. Embolization was most commonly performed with a combination of coils and N-butyl cyanoacrylate or vascular plugs. Complete MGV shunt thrombosis was achieved in 7/9 shunts post-embolization, and symptom improvement was noted in 7/8 patients. Child-Pugh scores improved post-embolization in 6/9 patients by a median of 3 points. Liver volumes also increased by a mean of 20.8 ± 17.7% post-embolization. Minor adverse events included new onset ascites, partial mesenteric/portal vein thrombosis, and new gastroesophageal varices without bleeding in four patients. Embolization of MGV shunts is technically feasible and effective for treatment of hepatic encephalopathy and increasing hepatopetal portal perfusion. There was an improvement in Child-Pugh scores and an increase in liver volumes in the majority of patients post-embolization.

Self-expanding metal stent for relieving the stricture after endoscopic injection for esophageal varices.

Esophageal stricture is one of the complications after esophageal varices sclerotherapy injection (ESI), and the incidence rate is between 2%-10%. To explore the efficacy of self-expanding metal stent (SEMS) for the stricture after endoscopic injection with cyanoacrylate (CYA) and sclerotherapy for esophageal varices. We retrospectively analyzed the efficacy of SEMS to improve the stricture after endoscopic injection with CYA and sclerotherapy for esophageal varices in 4 patients from February 2023 to June 2023. The strictures were improved in four patients after stenting. The stent was removed after two weeks because of chest pain with embedding into esophageal mucosa in one patient. The stent was removed after one month, however, the stent was reinserted because of the strictures happening again in two patients. The stent was removed after three months, however, the stent was reinserted because of the strictures happening again in one patient. The stent embedded into esophageal mucosa in three patients. There were 3 patients suffered reflux esophagitis, and the acid reflux was relieved by taking hydrotalcite. There was no other complication of esophageal perforation, bleeding from varices or infection. SEMS may relieve the stricture which happened after endoscopic injection with CYA and sclerotherapy for esophageal varices. However, when we should remove the stent still needs to be explored.

The efficacy, safety, and related factors of bronchial artery embolization for hemoptysis: a systematic review and meta-analysis with subgroup analysis.

Bronchial artery embolization (BAE) is a common and important way to manage hemoptysis. This study's purpose was to summarize the efficacy, safety, and related factors of BAE in the treatment of hemoptysis. From January 2010 to August 2023, a systematic literature search was conducted in PubMed, EMBASE, Web of Science, and Cochrane Library databases. Original studies with BAE for hemoptysis were included, with no restrictions on language. The outcomes of interest were technical success rate, clinical success rate, recurrence rate, mortality rate, and major complication rate. Pooled proportions with 95% confidence intervals (CIs) were calculated using random-effects models. The Newcastle-Ottawa Scale (NOS) was employed for quality assessment. Factors such as publication year, region, sample size, amount of hemoptysis, etiology, and embolization materials were extracted for subgroup analyses. Additionally, sensitivity analyses and test for publication bias were conducted. A total of 32 studies, including 6,032 patients, met our inclusion criteria. 27 studies were of high quality, while five of moderate quality. The results indicated the prevalence of technical success was 97.2% (95% CI: 95.1-98.8%) and 93.2% (95% CI: 90.3-95.7%) in clinical success. Hemoptysis recurrence and mortality rates after BAE were 24.8% (95% CI: 20.5-29.4%) and 2.3% (95% CI: 1.1-3.8%), respectively. Moreover, the pooled prevalence of major complication was 0.1% (95% CI: 0.0-0.4%). Subgroup analysis revealed that studies published after 2017 demonstrated a higher technical success rate and a lower recurrence rate. Massive hemoptysis showed a higher technical success rate but a lower clinical success rate. BAE also demonstrated superior efficacy in patients with bronchiectasis. The clinical success rate was significantly higher in patients with benign diseases than those with malignancies. Gelatin sponge (GS) showed poor embolization efficacy. N-butyl-2-cyanoacrylate (NBCA) and coils exhibited reduced recurrence rates, while NBCA displayed an even lower recurrence rate than non-absorbable particles. The study by Ishikawa et al. influenced the stability of the pooled major complication rate, and the sensitivity analysis confirmed the robustness of the remaining results. BAE is safe and effective in treating different degrees of hemoptysis caused by benign and malignant lesions. Promising clinical efficacy was observed with NBCA as an embolic material for the treatment of hemoptysis. However, further conclusions should be investigated using evidence-based medicine.

Comparison of Endoscopic Ultrasound-guided Cyanoacrylate Injection and Transjugular Intrahepatic Portosystemic Shunt in the Prevention of Gastric Varices Rebleeding.

The purpose of this study was to investigate the efficacy and safety of endoscopic ultrasound (EUS)-guided injection of cyanoacrylate (CYA) and transjugular intrahepatic portal shunts (TIPSs) in the treatment of patients with cirrhosis with ruptured gastric varices. In this retrospective study, 105 patients with liver cirrhosis and gastric varicose veins who were admitted to the First Affiliated Hospital of Anhui Medical University between April 2018 and April 2023 without nonselective β-blockers treatment and no portal vein thrombosis were evaluated. The patients were divided into the transjugular intrahepatic portal shunt (TIPS) group (n = 60) and the EUS-CYA group (n = 45) for the purpose of evaluating postoperative rebleeding rates, complications, survival rates, and other factors. During the follow-up, there was no significant difference in the rebleeding rates between the TIPS group and EUS-CYA group within 3 months (5% vs 2.2%; P = 0.825; 10% vs 20%, P = 0.147). However, the TIPS group had significantly lower rebleeding rates than the EUS-CYA group at 6 months (10% vs 33.3%; P = 0.030) and 1 year or longer (11.7% vs 42.2%; P < 0.01). In terms of hepatic encephalopathy, the incidence rate of the TIPS group was significantly higher than that of the EUS-CYA group (20% vs 2.2%; P = 0.006). In addition, there was no difference in the survival rates between the two groups (93.3% vs 97.8%; P = 0.552). TIPS is superior to EUS in preventing rebleeding in patients with ruptured varices of the fundus, but it has a higher incidence of hepatic encephalopathy, and there is no difference in long-term survival between the two groups.

Endovascular Treatment of Mycotic Intracranial Aneurysms: A Series of Three Cases with Institutional Treatment Algorithm

AbstractMycotic intracranial aneurysms (MIAs) are rare but can cause significant morbidity and mortality due to rupture. Most patients have additional systemic medical comorbidities making endovascular treatment a vital modality in the treatment of these aneurysms. We aimed to share our institutional experience with the role of endovascular therapy in the treatment of mycotic aneurysms with a literature review. We conducted a retrospective review of our patient database to identify individuals diagnosed with MIAs who underwent endovascular intervention at our institution between January 2002 and December 2021. We have found three patients with ruptured MIAs. All three patients had a heart disease with infective endocarditis. Two patients presented with subarachnoid hemorrhage (SAH) in which, one had a rebleed resulting in intracerebral hemorrhage (ICH), the third patient initially presented with ICH. Distal anterior cerebral artery (ACA) was the site of MIA in two cases and distal middle cerebral artery (MCA) in one patient. Two patients were treated with simple coiling and one patient was treated by glue (n-butyl cyanoacrylate [NBCAs]) injection within the aneurysm. There was no periprocedural complication with complete obliteration of the aneurysm and preservation of the parent artery. All the patients had good outcomes on follow-up. Two patients had a modified Rankin scale (mRS) score of 0 at 6 months and one patient had an mRS score of 3 at the end of 3 months whose preprocedure mRS score was 5. Endovascular embolization of MIAs with coils or liquid embolic agents can be performed in critically ill patients and is an excellent treatment modality with high occlusion rates and low procedural complications.

Middle Meningeal Artery Embolization for Chronic Subdural Hematoma Using N-Butyl Cyanoacrylate With a D5W Push Technique: A Multicentric North American Study of 269 Patients

BACKGROUND AND OBJECTIVES: As the aging population increases, the incidence of chronic subdural hematomas (cSDHs) is expected to rise. Surgical evacuation, though effective, sees up to 30% recurrence. Middle meningeal artery (MMA) embolization, particularly with n-butyl cyanoacrylate (n-BCA) glue diluted in D5W for distal penetration, has shown promise in reducing recurrences. Limited reports have investigated the safety and technical feasibility of n-BCA as a primary liquid embolic agent using the D5W push technique in cSDH. This series is the largest in the literature investigating the outcomes of this technique in cSDH. METHODS: A multicenter retrospective database analysis was conducted on consecutive patients who underwent MMA embolization using n-BCA embolisate. Data collected included patient demographics, procedural information, angiographic data, and periprocedural complications. RESULTS: The study included 269 patients with a median age of 76 years. Nearly half of the patients had previous surgeries, and 93 underwent contralateral embolization for bilateral cSDH. Successful MMA embolization with effective distal penetration was achieved in all cases. The complication rate was 2.2%. Significant improvements were noted at a 60-day follow-up, with a median reduction in cSDH diameter of 40.6% (P &lt; .001) and 53% of patients showing neurological improvement. No recurrent cSDH or need for retreatment was observed in patients who underwent follow-up. CONCLUSION: MMA embolization using n-BCA with the D5W push technique is safe and technically feasible. It can be used adjunctively or as an alternative to surgery in patients with cSDH, resulting in decreased recurrence, high technical success, improved distal penetration, and low complication rates.

Clinical Efficacy and Safety of Using N-Butyl Cyanoacrylate in the Treatment of Perforator Vein Insufficiency

Clinical Efficacy and Safety of Using N-Butyl Cyanoacrylate in the Treatment of Perforator Vein Insufficiency

ThP8.4 - Initial Results of CAC (Cyanoacrylate Closure) of lower limb truncal venous incompetence

Abstract Aims We have tried CAC in our unit, as an emerging new treatment. We present our initial experience on efficacy and safety of the technique. Methods Venous trunks were treated with n-butyl Cyanoacrylate (Variclose® by biolas) as per IFU. Clinical and doppler US follow-up at three months was carried out. Data was captured prospectively. Results Eighty-six venous trunks (79 GSV, 5 SSV, 2 ATV) in 82 limbs of 65 patients were treated. Median length/ diameter of LSV treated was 32 /0.7 cms; 15/5 cms for SSV. Median volume of glue used was 1.83 mls. Eighty-two out of eighty-six (96%) trunks were successfully treated with complete primary occlusion. Four(4.5%) trunks did not demonstrate total occlusion at primary treatment. There was no extension of thrombus into deep veins and no immediate adverse reactions. On doppler US at 3 months, 58(70.7%) trunks demonstrated total occlusion. Twenty-four (29.3%) trunks were only partially occluded. which were deemed not suitable for thermal endovenous treatment. Nine (11%) patients had adverse events. One had pulmonary embolism two days after treatment. Five limbs developed erythema and swelling in the thigh which took few weeks to settle. Two patients had exaggerated thrombophlebitis of the treated GSV requiring hospital admission. Conclusion There is a high rate of primary occlusion of the treated trunk which does not appear to be maintained at short term follow up. There is glue associated adverse reactions and potential serious complications. It may limit the options of subsequent treatment where the glue treatment has not been successful.

Aminolysis-mediated single-step surface functionalization of poly (butyl cyanoacrylate) microbubbles for ultrasound molecular imaging

Molecular ultrasound imaging with actively targeted microbubbles (MB) proved promising in preclinical studies but its clinical translation is limited. To achieve this, it is essential that the actively targeted MB can be produced with high batch-to-batch reproducibility with a controllable and defined number of binding ligands on the surface. In this regard, poly (n-butyl cyanoacrylate) (PBCA)-based polymeric MB have been used for US molecular imaging, however, ligand coupling was mostly done via hydrolysis and carbodiimide chemistry, which is a multi-step procedure with poor reproducibility and low MB yield. Herein, we developed a single-step coupling procedure resulting in high MB yields with minimal batch-to-batch variation. Actively targeted PBCA-MB were generated using an aminolysis protocol, wherein amine-containing cRGD was added to the MB using lithium methoxide as a catalyst. We confirmed the successful conjugation of cRGD on the MB surface, while preserving their structure and acoustic signal. Compared to the conventional hydrolysis protocol, aminolysis resulted in higher MB yields and better reproducibility of coupling efficiency. Optical imaging revealed that under flow conditions, cRGD- and rhodamine-labelled MB, generated by aminolysis, specifically bind to tumor necrosis factor-alpha (TNF-α) activated endothelial cells in vitro. Furthermore, US molecular imaging demonstrated a markedly higher binding of the cRGD-MB than of control MB in TNF-α activated mouse aortas and 4T1 tumors in mice. Thus, using the aminolysis based conjugation approach, important refinements on the production of cRGD-MB could be achieved that will facilitate the production of clinical-scale formulations with excellent binding and ultrasound imaging performance.Graphical

Effects of Soaking Sannabis Cuttings in Rhizotonic on the Growth and Yield of Super Glue Cannabis Strains on Hydroponic Cultivation

Effects of Soaking Sannabis Cuttings in Rhizotonic on the Growth and Yield of Super Glue Cannabis Strains on Hydroponic Cultivation

Super Glue Removal

Super Glue Removal

A novel low-cost and simple fabrication technique for a paper-based analytical device using super glue

BackgroundThe microfluidic paper-based analytical devices (μPADs) have been highly regarded as effective tools that offer a cost-effective and portable solution for point-of-care testing (POCT) and on-site detection. Utilizing paper substrates such as cellulose and nitrocellulose membranes, μPADs have proven beneficial for a range of applications from medical diagnostics to environmental monitoring. Despite their advantages, the fabrication of μPADs often requires sophisticated techniques and equipment, posing challenges for widespread adoption, especially in resource-limited settings. This study addresses the need for a simplified, low-cost method for fabricating μPADs that is accessible without specialized training or equipment. ResultsThis research introduces a novel, efficient method for producing μPADs using 3D-printed slidable chambers and super glue vapor, bypassing traditional, more complex fabrication processes. The method utilizes super glue (ethyl-cyanoacrylate) vapor to create hydrophobic barriers on paper substrates. By optimizing the exposure sequence to super glue and water vapors and the heating conditions, we achieved rapid hydrophobization within 5 min, creating effective hydrophobic barriers and hydrophilic channels on paper substrates. The technique's simplicity allows for use by individuals without specialized training. The practical application of the fabrication method is demonstrated by the fabrication of μPADs that can detect multiple target analytes. We perform the simultaneous detection of glucose, proteins, and also the simultaneous detection of heavy metal ions nickel (Ni2+) and copper (Cu2+), highlighting its potential for broad applications in point-of-care diagnostics. SignificanceThis study is the first to report a method for selective exposure of ethyl-cyanoacrylate vapor for the fabrication of μPADs. This method significantly reduces the complexity, time, and fabrication cost, making it feasible for use in various settings. It also eliminates the need for specialized equipment and can be executed by individuals without specialized training. We believe that the proposed fabrication method contributes to the wider adoption and deployment of μPADs across various sectors.

Spinal epidural arteriovenous fistula with an intraosseous shunt arising in a compression fracture vertebra: illustrative case.

Spinal epidural arteriovenous fistulas (SEAVFs) with intraosseous shunts are rare, and their underlying pathophysiological mechanisms remain unclear. A female in her 70s presented with rapidly progressive weakness in both lower extremities and urinary retention. Lumbar spine magnetic resonance imaging revealed spinal cord edema and flow voids due to venous dilation and compression fractures of the L1 and L2 vertebral bodies. Spinal angiography revealed ventral and dorsal somatic branches of the lumbar arteries at L1 and L2 flowing into the shunt. High-resolution cone-beam computed tomography revealed a shunt within the compression-fractured vertebral body bone of L2. The intravertebral shunt blood flowed into the ventral epidural venous plexus (VEVP) and returned into the perimedullary vein (PMV). Transarterial embolization was performed using N-butyl cyanoacrylate and Onyx-18 for feeder L1 and feeder L2, respectively. Onyx-18 was injected from the VEVP into the PMV, and complete occlusion of the shunt was achieved. The patient showed symptomatic improvement postoperatively. Vertebral compression fractures are common but rarely associated with SEAVFs. https://thejns.org/doi/10.3171/CASE2457.

Endovascular transvenous treatment of carotid–cavernous fistula

Carotid–cavernous fistulas represent abnormal communication between the carotid circulation and the cavernous sinus. They can be classified as direct or indirect. The Barrow classification is the most widely used system that categorizes the carotid–cavernous fistulas based on their arterial supply (type A–D). The mainstay of therapy for carotid–cavernous fistulas consists of transarterial or transvenous embolization, while other treatment options such as open surgery or radiosurgery are still utilized as second-line or adjuvant therapeutic options. We present the case of a 72-year-old female patient with conjunctival chemosis and exophthalmos. Computed tomography angiography detected a carotid–cavernous fistula that was confirmed with catheter angiography (Barrow type C). Through right femoral vein catheterization, detachable coils were deployed in the right cavernous sinus, adjacent to the fistula shunt point. The procedure was completed with N-butyl cyanoacrylate injection (dilution 1:2). At post-procedural digital subtraction angiography, the fistula was excluded. Endovascular transvenous treatment is a valid therapeutic option for indirect carotid–cavernous fistulas.

Uneventful salvage for partial deployment of a coil via endoscopic ultrasound in the treatment of rebleeding gastric varices.

A 72-year-old female who had received emergent endoscopic cyanoacrylate (CYA) injection for bleeding gastric varices (GV) two month before was readmitted due to recurrence of melena. Current gastroscopy verified the type-2 GV (GOV-2) according to Sarin's classification with stigmata of recent bleeding. Endoscopic ultrasound (EUS) identified the largest varix of 8.7mm in diameter, which prompted us to consider EUS-guided coiling combined with CYA injection as an alternative therapeutic strategy, considering the short interval between prior injection and rebleeding. Via trans-esophageal route, the abovementioned varix was punctured using a 19-gauge FNA needle preloaded with a 0.035-inch coil with diameter of 10mm and length of 14cm (Nester, Cook Medical, Bloomington, IN). Initially, the stylet used as a pusher was advanced smoothly and part of the coil was visualized to have been pushed out of the needle tip. However, the stylet could not be fully advanced to place the entire coil into the varix due to substantial resistance, which, regardless of the endeavor to adjust the needle, was not diminished.

Management of refractory rectal variceal bleed using computed tomography.

The management of refractory rectal variceal bleed using a minimally invasive percutaneous approach is described. Rectal varices are portosystemic collaterals that arise as a complication of portal hypertension. Bleeding is less common from rectal varices than from esophageal varices, but it is potentially life-threatening. Hence, it is of interest to describe a novel minimally invasive percutaneous technique to control refractory bleeding from rectal varices in a complex scenario where other proven treatments have failed. In the present study, a 28-year-old male presented to the Emergency department with one episode of hematemesis, hematochezia and severe abdominal pain. Sigmoidoscopy revealed actively bleeding rectal varices. CT abdominal angiogram revealed variceal formation in the rectum. we successfully performed CT guided percutaneous N- butyl cyanoacrylate (NBCA) glue injection of rectal varices with immediate and complete cessation of rectal bleed after failed endoscopic sclerotherapy.