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CardioVascular and Interventional Radiology

, Volume 36, Issue 3, pp 690–698 | Cite as

N-butyl Cyanoacrylate Glue Embolization of Arterial Networks to Facilitate Hepatic Arterial Skeletonization before Radioembolization

  • Shaun D. Samuelson
  • John D. Louie
  • Daniel Y. Sze
Clinical Investigation

Abstract

Purpose

Avoidance of nontarget microsphere deposition via hepatoenteric anastomoses is essential to the safety of yttrium-90 radioembolization (RE). The hepatic hilar arterial network may remain partially patent after coil embolization of major arteries, resulting in persistent risk. We retrospectively reviewed cases where n-butyl cyanoacrylate (n-BCA) glue embolization was used to facilitate endovascular hepatic arterial skeletonization before RE.

Methods

A total of 543 RE procedures performed between June 2004 and March 2012 were reviewed, and 10 were identified where n-BCA was used to embolize hepatoenteric anastomoses. Arterial anatomy, prior coil embolization, and technical details were recorded. Outcomes were reviewed to identify subsequent complications of n-BCA embolization or nontarget RE.

Results

The rate of complete technical success was 80 % and partial success 20 %, with one nontarget embolization complication resulting in a minor change in treatment plan. No evidence of gastrointestinal or biliary ischemia or infarction was identified, and no microsphere-related gastroduodenal ulcerations or other evidence of nontarget RE were seen. Median volume of n-BCA used was <0.1 ml.

Conclusion

n-BCA glue embolization is useful to eliminate hepatoenteric networks that may result in nontarget RE, especially in those that persist after coil embolization of major vessels such as the gastroduodenal and right gastric arteries.

Keywords

n-BCA Radioembolization Skeletonization Supraduodenal 

Notes

Conflict of interest

Daniel Sze is a consultant to Abbott Vascular, Inc., a speaker for W. L. Gore, Inc., and a scientific/medical advisory board member of Jennerex Biotherapeutics, Inc., Treus Medical, Inc., RadGuard Medical, Inc., and SureFire Medical, Inc. Shaun Samuelson and John Louie have no disclosures.

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Copyright information

© Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2012

Authors and Affiliations

  • Shaun D. Samuelson
    • 1
  • John D. Louie
    • 1
  • Daniel Y. Sze
    • 1
  1. 1.Division of Interventional RadiologyStanford University School of MedicineStanfordUSA

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