American Journal of Neuroradiology 23:129-138, January 2002
© 2002 American Society of Neuroradiology
INTERVENTIONAL
Cyanoacrylate Embolization of Experimental Aneurysms
a Centre de Recherche, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame
b Department of Radiology, Université de Montréal, Montréal, Québec, Canada
c Department of Pathology, Université de Montréal, Montréal, Québec, Canada
Address reprint requests to Jean Raymond, MD, Department of Radiology, Centre Hospitalier de l’Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Street East, Montreal, Québec, H2L 4M1 Canada
BACKGROUND AND PURPOSE: Cyanoacrylates are effective occlusive agents in neurovascular interventions. To study their potential to improve long-term results of endovascular treatment of aneurysms, we conducted experimental studies in canine aneurysm models.
METHODS: Venous pouch carotid aneurysms were constructed in dogs. Results of coil embolization of lateral wall and bifurcation aneurysms were compared. A lateral wall model of embolization with gelatin sponges was used to study the effects of coating sponges with cyanoacrylate on angiographic results and neointima thickness at 3 and 12 weeks. These models were also used to investigate the control of endovascular cyanoacrylate deposition, alone or over a coil placed at the neck of the treated lesions. The results of endovascular cyanoacrylate embolization of bifurcation aneurysms were compared with those of coil embolization at 3 months.
RESULTS: Bifurcation aneurysms treated with coils showed more frequent recurrences (P < .01) and thinner neointimas (P < .01) at 3 months than did lateral wall aneurysms. Cyanoacrylate-coated sponges improved angiographic results (P < .05) and led to thicker neointimas at 3 and 12 weeks (P < .05) as compared with uncoated sponges. Endovascular cyanoacrylate deposition with microcatheters led to stray emboli in all cases. Cyanoacrylate delivery was improved by a single coil positioned at the neck of the aneurysm, but parent vessel embolization still occurred in 25% of the animals. Cyanoacrylate embolization of bifurcation aneurysms improved angiographic results at 3 months as compared with coil embolization (P < .01).
CONCLUSION: Cyanoacrylate embolization is currently difficult to control. It has the potential to decrease recurrences after endovacular treatment of aneurysms, but a safe method for endovascular delivery has yet to be developed.
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