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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:938-944, June-July 2002
© 2002 American Society of Neuroradiology

INTERVENTIONAL

Effect of Glacial Acetic Acid and Ethiodized Oil Concentration on Embolization with N-Butyl 2-Cyanoacrylate: An in Vivo Investigation

Matthew J. Gounis^a, Baruch B. Lieber^a,b, Ajay K. Wakhloo^b,c, Ralf Siekmann^d and L.N. Hopkins^e

^a Department of Biomedical Engineering, University of Miami, Miami, FL
^b Department of Radiology, University of Miami, Miami, FL
^c Department of Neurological Surgery, University of Miami, Miami, FL
^d the Center for Radiology, Giessen University, Giessen, Germany
^e Department of Neurosurgery, State University of New York at Buffalo, Buffalo, NY

Address reprint requests to Matthew Gounis, Hemodynamics Laboratory, Department of Biomedical Engineering, University of Miami, PO Box 248294, Coral Gables, FL 33124

BACKGROUND AND PURPOSE: Precise control of the polymerization dynamics of cyanoacrylate mixtures used in the embolization of cerebral arteriovenous malformations is required to achieve a safe and permanent obliteration of the lesion. In this study, in vivo embolization using mixtures of Histoacryl, Lipiodol Ultra-Fluid, and glacial acetic acid (GAA) was investigated. The present study investigated whether increased ethiodized oil concentration or the addition of GAA increased rate of embolization.

METHODS: Using embolic mixtures containing Histoacryl (N-butyl 2-cyanoacrylate [NBCA]), the embolization process in the femoral and subclavian arteries of the rabbit was examined. Various embolic agents composed of ethiodized oil and N-BCA mixtures, either with or without the addition of minute quantities of GAA, were injected. Blood flow through the aforementioned arteries was measured during embolization. The transient decay of blood flow to zero was modeled, and an optimized model parameter, termed the time elapsed to flow arrest (TEFA) factor, was compared with the experimental data related to the embolization process.

RESULTS: The TEFA factor was independent of the variation of the ethiodized oil concentration in the mixture (P > .05). In contradistinction, the addition of GAA significantly increased the TEFA factor (P < .05). Moreover, a linear relation between the TEFA factor and the quantity of GAA in the mixture was discerned.

CONCLUSION: Predictable control of the embolization process with N-BCA in vivo is attained by varying the amount of GAA in the embolic mixture.

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