Endovascular Use of Cyanoacrylate-Lipiodol Mixture for Peripheral Embolization: Properties, Techniques, Pitfalls, and Applications

Overview

Journal J Clin Med

Specialty General Medicine

Date 2021 Oct 13

PMID 34640339

Citations 11

Authors

Pierre-Olivier Comby

Kevin Guillen

Olivier Chevallier

Marc Lenfant

Julie Pellegrinelli

Nicolas Falvo

Marco Midulla

Romaric Loffroy

Affiliations

Soon will be listed here.

Abstract

Endovascular embolization agents are particles and fluids that can be released into the bloodstream through a catheter to mechanically and/or biologically occlude a target vessel, either temporarily or permanently. Vascular embolization agents are available as solids, liquids, and suspensions. Although liquid adhesives (glues) have been used as embolic agents for decades, experience with them for peripheral applications is generally limited. Cyanoacrylates are the main liquid adhesives used for endovascular interventions and have a major role in managing vascular abnormalities, bleeding, and many vascular diseases. They can only be injected as a mixture with ethiodized oil, which provides radiopacity and modulates the polymerization rate. This review describes the characteristics, properties, mechanisms of action, modalities of use, and indications of the cyanoacrylate-Lipiodol combination for peripheral embolization.

Citing Articles

Embolic Effect of Different Cyanoacrylates: Radiological and Histological Comparison in an In Vivo Rabbit Renal-Artery Model.

Comby P, Guillen K, Chevallier O, Couloumy E, Dencausse A, Robert P Cardiovasc Intervent Radiol. 2025; .

PMID: 40064655 DOI: 10.1007/s00270-025-03997-w.

NBCA: Basic Knowledge.

Kidani N, Hirotsune N J Neuroendovasc Ther. 2025; 19(1).

PMID: 40018282 PMC: 11864999. DOI: 10.5797/jnet.ra.2024-0055.

Novel Application of a Shear-Thinning Conformable Embolic Gel for Occlusion of a Bronchobiliary Fistula.

Al-Asadi Z, Korona M, Deipolyi A Cardiovasc Intervent Radiol. 2025; 48(2):277-279.

PMID: 39809883 DOI: 10.1007/s00270-024-03928-1.

Glue and Ethanol Mixture for Aneurysm Endovascular Treatment: Animal Lab Study, Imaging, and Histopathological Findings.

Muto M, Leone G, Giordano F, Guarnieri G, Di Donna A, Andreone V J Clin Med. 2024; 13(23).

PMID: 39685680 PMC: 11642053. DOI: 10.3390/jcm13237222.

Successful Management of Periprocedural Coronary Extravasation Using Liquid Embolic Agent n-Hexyl-Cyanoacrylate.

Sirvys A, Berukstis A J Cardiovasc Dev Dis. 2024; 11(11).

PMID: 39590190 PMC: 11595038. DOI: 10.3390/jcdd11110347.

References

Mendes Luz J, Gomes F, Vasco Costa N, Vasco I, Coimbra E, Luz P . BestFLR Trial: Liver Regeneration at CT before Major Hepatectomies for Liver Cancer-A Randomized Controlled Trial Comparing Portal Vein Embolization with -Butyl-Cyanoacrylate Plus Iodized Oil versus Polyvinyl Alcohol Particles Plus Coils. Radiology. 2021; 299(3):715-724. DOI: 10.1148/radiol.2021204055. View

Hekster R, Matricali B, LUYENDIJK W . Presurgical transfemoral catheter embolization to reduce operative blood loss. Technical note. J Neurosurg. 1974; 41(3):396-8. DOI: 10.3171/jns.1974.41.3.0396. View

DeWire D, Thomas Jr A, Falk R, Geisinger M, Lammert G . Clinical outcome and cost comparison of percutaneous embolization and surgical ligation of varicocele. J Androl. 1994; 15 Suppl:38S-42S. View

Rossi G, Rimondi E, Bartalena T, Gerardi A, Alberghini M, Staals E . Selective arterial embolization of 36 aneurysmal bone cysts of the skeleton with N-2-butyl cyanoacrylate. Skeletal Radiol. 2009; 39(2):161-7. DOI: 10.1007/s00256-009-0757-z. View

Tanaka T, Kawai N, Sato M, Ikoma A, Nakata K, Sanda H . Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model. World J Radiol. 2013; 4(12):455-61. PMC: 3543995. DOI: 10.4329/wjr.v4.i12.455. View

Abdulmalak G, Chevallier O, Falvo N, Di Marco L, Bertaut A, Moulin B . Safety and efficacy of transcatheter embolization with Glubran2 cyanoacrylate glue for acute arterial bleeding: a single-center experience with 104 patients. Abdom Radiol (NY). 2017; 43(3):723-733. DOI: 10.1007/s00261-017-1267-4. View

Almeida J, Kaufman J, Gockeritz O, Chopra P, Evans M, Hoheim D . Radiofrequency endovenous ClosureFAST versus laser ablation for the treatment of great saphenous reflux: a multicenter, single-blinded, randomized study (RECOVERY study). J Vasc Interv Radiol. 2009; 20(6):752-9. DOI: 10.1016/j.jvir.2009.03.008. View

Ali A, Ahle M, Bjornsson B, Sandstrom P . Portal vein embolization with N-butyl cyanoacrylate glue is superior to other materials: a systematic review and meta-analysis. Eur Radiol. 2021; 31(8):5464-5478. DOI: 10.1007/s00330-020-07685-w. View

Levrier O, Mekkaoui C, Rolland P, Murphy K, CABROL P, Moulin G . Efficacy and low vascular toxicity of embolization with radical versus anionic polymerization of n-butyl-2-cyanoacrylate (NBCA). An experimental study in the swine. J Neuroradiol. 2003; 30(2):95-102. View

10.

Loffroy R . Which Acrylic Glue Should Be Used for Transcatheter Arterial Embolization of Acute Gastrointestinal Tract Bleeding?. AJR Am J Roentgenol. 2015; 205(4):W465. DOI: 10.2214/AJR.15.14874. View

11.

Tanaka F, Kawai N, Sato M, Minamiguchi H, Nakai M, Nakata K . Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study. Jpn J Radiol. 2015; 33(8):517-22. DOI: 10.1007/s11604-015-0451-0. View

12.

Ali A, Wirth S, Treitl K, Treitl M . Treatment of male varicoceles by transcatheter polidocanol foam sclerotherapy: evaluation of clinical success, complications, and patients' satisfaction with regard to alternative techniques. Eur Radiol. 2015; 25(10):2889-97. DOI: 10.1007/s00330-015-3684-5. View

13.

Yasim A, Eroglu E, Bozoglan O, Mese B, Acipayam M, Kara H . A new non-tumescent endovenous ablation method for varicose vein treatment: Early results of N-butyl cyanoacrylate (VariClose®). Phlebology. 2016; 32(3):194-199. DOI: 10.1177/0268355516638577. View

14.

Jawhari R, Chevallier O, Falvo N, dAthis P, Gehin S, Charles P . Outcomes of Transcatheter Arterial Embolization with a Modified N-Butyl Cyanoacrylate Glue for Spontaneous Iliopsoas and Rectus Sheath Hematomas in Anticoagulated Patients. J Vasc Interv Radiol. 2017; 29(2):210-217. DOI: 10.1016/j.jvir.2017.08.006. View

15.

Bozkurt A, Yilmaz M . A prospective comparison of a new cyanoacrylate glue and laser ablation for the treatment of venous insufficiency. Phlebology. 2016; 31(1 Suppl):106-13. DOI: 10.1177/0268355516632652. View

16.

Bouwman F, Botden S, Verhoeven B, Schultze Kool L, van der Vleuten C, de Blaauw I . Treatment Outcomes of Embolization for Peripheral Arteriovenous Malformations. J Vasc Interv Radiol. 2020; 31(11):1801-1809. DOI: 10.1016/j.jvir.2019.12.811. View

17.

Lord J, Britton H, Spain S, Lewis A . Advancements in the development on new liquid embolic agents for use in therapeutic embolisation. J Mater Chem B. 2020; 8(36):8207-8218. DOI: 10.1039/d0tb01576h. View

18.

Tanaka F, Kawai N, Sato M, Minamiguchi H, Nakai M, Nakata K . Effect of transcatheter arterial embolization with a mixture of n-butyl cyanoacrylate, lipiodol, and ethanol on the vascular wall: macroscopic and microscopic studies. Jpn J Radiol. 2015; 33(7):404-9. DOI: 10.1007/s11604-015-0432-3. View

19.

Loffroy R, Guillen K, Comby P, Chevallier O . Adjunctive Component to N-Butyl Cyanoacrylate-Lipiodol Mixture for Best Embolic Profile in Vivo: Ethanol or Iopamidol?. Cardiovasc Intervent Radiol. 2021; 44(9):1467-1468. DOI: 10.1007/s00270-021-02867-5. View

20.

Chevallier O, Comby P, Guillen K, Pellegrinelli J, Mouillot T, Falvo N . Efficacy, safety and outcomes of transcatheter arterial embolization with N-butyl cyanoacrylate glue for non-variceal gastrointestinal bleeding: A systematic review and meta-analysis. Diagn Interv Imaging. 2021; 102(7-8):479-487. DOI: 10.1016/j.diii.2021.03.004. View