Japanese Journal of Radiology

, Volume 33, Issue 8, pp 517–522 | Cite as

Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study

  • Fumihiro Tanaka
  • Nobuyuki Kawai
  • Morio SatoEmail author
  • Hiroki Minamiguchi
  • Motoki Nakai
  • Kouhei Nakata
  • Hiroki Sanda
  • Tetsuo Sonomura
Technical Note



To evaluate the feasibility of balloon-assisted packing with a mixture of n-butyl cyanoacrylate (NBCA), Lipiodol, and ethanol for wide-neck aneurysms.

Materials and methods

Of 10 carotid aneurysms with wide necks created in a swine model, 3 aneurysms (long and short diameters 10.9 × 9.8 mm; neck width 8.3 ± 1.2 mm (mean ± SD)) and 7 aneurysms (11.2 × 9.5 mm; neck width 8.3 ± 1.4 mm) were packed with a mixture of NBCA, Lipiodol, and ethanol in the ratios 1:1:0 (NL11) and 1:1:2 (NLE112), respectively. A microcatheter was advanced into the aneurysm and a balloon catheter was inflated at the aneurysm neck. Ten minutes after injection, the balloon catheter was deflated and its removal was attempted.


For all three aneurysms in the NL11 group, the balloon catheter and the microcatheter adhered strongly to the vessel and could not be adjusted. For all seven aneurysms in the NLE112 group, both the balloon catheter and the microcatheter could be easily removed, which enabled successful full packing of the aneurysm by re-advancing the microcatheter and re-injecting NLE112 after re-inflation of the balloon catheter.


Although at a preliminary stage, balloon-assisted NLE injection is feasible for packing a wide-neck aneurysm.


Ethanol n-Butyl cyanoacrylate Lipiodol Balloon-assisted packing Aneurysm 


Conflict of interest

All the authors declare that they have no conflict of interest.


  1. 1.
    American Society for Gastrointestinal Endoscopy Assessment Committee Technology. Status evaluation report: tissue adhesives and fibrin glues. Gastrointest Endosc. 2004;60:327–33.CrossRefGoogle Scholar
  2. 2.
    Stoesslein F, Ditscherlein G, Romaniuk PA. Experimental studies on new liquid embolization mixtures (histoacryl-Lipiodol, histoacryl-panthopaque). Cardiovasc Intervent Radiol. 1982;5:264–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Spiegel SM, Vinuela F, Goldwasser JM, Fox AJ, Pelz DM. Adjusting the polymerization time of isobutyl-2 cyanoacrylate. AJNR Am J Neuroradiol. 1986;7:109–12.PubMedGoogle Scholar
  4. 4.
    Gounis MJ, Lieber BB, Wakhloo AK, Siekmann R, Hopkins LN. Effect of glacial acetic acid and ethiodized oil concentration on embolization with n-butyl 2-cyanoacrylate: an in vivo investigation. AJNR Am J Neuroradiol. 2002;23:938–44.PubMedGoogle Scholar
  5. 5.
    Kawai N, Sato M, Minamiguchi H, Ikoma A, Sanda H, Nakata K, et al. Basic study of a mixture of n-butyl cyanoacrylate, ethanol, and Lipiodol as a new embolic material. J Vasc Radiol. 2012;23:1516–21.CrossRefGoogle Scholar
  6. 6.
    Toyoda H, Nakano S, Kumada T, Takeda I, Sugiyama K, Osada T, et al. Estimation of n-butyl-2 cyanoacrylate-Lipiodol mixture in transcatheter arterial embolization for urgent control of life-threatening massive bleeding from gastric or duodenal ulcer. J Gastr Hepat. 1996;11:252–8.CrossRefGoogle Scholar
  7. 7.
    Kish JW, Katz MD, Marx V, Harrell DS, Hanks SE. n-Butyl cyanoacrylate embolization for control of acute arterial hemorrhage. J Vasc Interv Radiol. 2004;15:689–95.CrossRefPubMedGoogle Scholar
  8. 8.
    Yonemitsu T, Kawai N, Sato M, Tanihata H, Takasaka I, Nakai M, et al. Evaluation of transcatheter arterial embolization with gelatin sponge particles, microcoils, and n-butyl cyanoacrylate for acute arterial bleeding in a coagulopathic condition. J Vasc Interv Radiol. 2009;20:1176–87.CrossRefPubMedGoogle Scholar
  9. 9.
    Debrun GM, Aletich VA, Shownkeen H, Ausman J. Glued catheters during embolization of brain AVMs with acrylic glue. Interv Neuroradiol. 1997;30:13–9.Google Scholar
  10. 10.
    The n-BCA trial investigation. n-Butyl cyanoacrylate embolization of cerebral arteriovenous malformations: results of a prospective, randomized, multi-center trial. AJNR Am J Neuroradiol. 2002;23:748–55.Google Scholar
  11. 11.
    Zubillage AF, Guglielmi G, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol. 1994;15:815–20.Google Scholar
  12. 12.
    Debrun GM, Aletich VA, Kehrli P, Misra M, Ausman JI, Charbel F. Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: the preliminary University of Illinois at Chicago experience. Neurosurgery. 1998;43:1281–95.PubMedGoogle Scholar
  13. 13.
    Gad SC. Pharmaceutical manufacturing handbook. Production and processes. Hoboken: Wiley; 2008. p. 364–7.CrossRefGoogle Scholar
  14. 14.
    Miller CA. Spontaneous emulsification produced by diffusion—a review. Colloids Surf. 1988;29:89–102.CrossRefGoogle Scholar

Copyright information

© Japan Radiological Society 2015

Authors and Affiliations

  • Fumihiro Tanaka
    • 1
  • Nobuyuki Kawai
    • 1
  • Morio Sato
    • 1
    Email author
  • Hiroki Minamiguchi
    • 1
  • Motoki Nakai
    • 1
  • Kouhei Nakata
    • 1
  • Hiroki Sanda
    • 1
  • Tetsuo Sonomura
    • 1
  1. 1.Department of RadiologyWakayama Medical UniversityWakayamaJapan

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