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Determination of the Optimal Ratio and the Relationship Between Viscosity and Adhesion of n-Butyl Cyanoacrylate–Lipiodol–Iopamidol for Balloon-Assisted Embolization of Wide-Neck Aneurysms in Swine

  • Laboratory Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the optimal ratio of n-butyl cyanoacrylate–Lipiodol–iopamidol (NLI) for balloon-assisted embolization of wide-neck aneurysms in swine.

Materials and Methods

Sixteen NLI mixtures were prepared for in vitro studies. The viscosity of each mixture was measured for 30 min. We evaluated whether the mixtures could be injected through a microcatheter and whether they adhered to the microcatheter. In vivo, 15 wide-neck aneurysms were created on the arteries in 4 female swine. Under balloon occlusion, 7 aneurysms were embolized with NLI141 (NBCA:Lipidol:iopamidol = 1:4:1) and 8 were embolized with NLI231. We performed angiography to evaluate adhesion of NLI to the balloons or microcatheters and NLI migration.

Results

In vitro, the iopamidol content needed to comprise at least 1/6 of the mixture in order for NLI to be non-adhesive with increased viscosity. NLI could not be injected through a microcatheter if the iopamidol content exceeded 1/6 of the mixture. Only NLI141 and NLI231 did not adhere to the microcatheter with increased viscosity, and could be injected through a microcatheter. In vivo, neither NLI mixture adhered to the balloons or microcatheters. The migration of NLI was observed in 6 of 7 aneurysms embolized with NLI141 and in none of 8 aneurysms embolized with NLI231.

Conclusion

Our in vitro study revealed that the ratios of NLI that were non-adhesive and could be injected through a microcatheter were 1:4:1 and 2:3:1. The optimal ratio of NLI for balloon-assisted embolization of wide-neck aneurysms in swine was considered to be 2:3:1.

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Funding

This study was not supported by any funding.

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Authors and Affiliations

  1. Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayamashi, Wakayama, 641-8509, Japan

    Kodai Fukuda, Nobuyuki Higashino, Tetsuo Sonomura, Ryuta Okuhira, Masataka Koike, Akira Ikoma, Nobuyuki Kawai & Hiroki Minamiguchi

Authors
  1. Kodai Fukuda
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  2. Nobuyuki Higashino
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  3. Tetsuo Sonomura
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  4. Ryuta Okuhira
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  5. Masataka Koike
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  6. Akira Ikoma
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  7. Nobuyuki Kawai
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  8. Hiroki Minamiguchi
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Correspondence to Kodai Fukuda.

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All applicable international, national, and institutional guidelines for the care and use of animals were followed. All procedures involving animals were performed in accordance with the ethical standards of the institution at which the studies were conducted.

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Fukuda, K., Higashino, N., Sonomura, T. et al. Determination of the Optimal Ratio and the Relationship Between Viscosity and Adhesion of n-Butyl Cyanoacrylate–Lipiodol–Iopamidol for Balloon-Assisted Embolization of Wide-Neck Aneurysms in Swine. Cardiovasc Intervent Radiol 45, 357–364 (2022). https://doi.org/10.1007/s00270-021-03055-1

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