With regard to the TAE materials, coils were used in 18 arteries (mean, 3.8 coils per artery) with the "two-point" technique, mainly for the SpA and GDA; NBCA
was used in 9 arteries (1:1 to 1:3 dilution with lipiodol), mainly for the GDA and PDA arcade; and gelfoam was used in 4 arteries with coils using the "sandwich" technique.
Several types of agents are available, including non-calibrated PVA particles (Contour; Boston Scientific, Marlborough, Massachusetts), acrylic polymer microspheres impregnated with gelatin (Embosphere Microspheres, Biosphere Medical, Rockland, MA) and calibrated PVA microspheres (Beadblock, Terumo, Leuven, Belgium), liquid embolic agents including NBCA
In this case, permanent distal branch embolization with 15% NBCA-iodized oil mixture was performed after highly selective catheterization of the branch with the co-axial microcatheter since NBCA
has been reported to provide faster and more effective embolization in distal branches (2).
Patient Cause of PH Child-Pugh Acute Class bleed (1) 57y/F PBC A No (2) 74y/M Alcohol A No (3) 50y/M HCV A No (4) 51y/M HBV B Yes (5) 52y/F PBC B Yes Patient Preoperative drug Endoscopic findings (1) 57y/F None F0/IGV1 (2) 74y/M None F2/GOV2 (3) 50y/M None F3/GOV2 Aminomethylbenzoic acid 0.4 g Etamsylate 2 g (4) 51y/M Carbazochrome 80 mg F3/GOV2 Hemocoagulase 1IU Somatostatin 6 mg Carbazochrome 80 mg (5) 52y/F Hemocoagulase 1 IU F3/GOV2 Somatostatin 6 mg Patient Endoscopic Volume of treatment cyanoacrylate (1) 57y/F NBCA
3.5ml (2) 74y/M NBCA
+ EIS 3ml (3) 50y/M NBCA
+ EBL 3.5ml (4) 51y/M NBCA
+ EBL 2.5ml (5) 52y/F NBCA
+ EBL 1ml TABLE 2: Postoperative events including subsequent severe adverse event (SAE), patient outcome, and probable cause.
In our case, NBCA
was employed over microcoil for technical considerations outlined above.
The purpose of our study was to evaluate the effectiveness of TAE using a mixture of N-butyl-2-cyanoacrylate (NBCA
) and iodized oil, an embolic material different from previous reports, for patients with severe symptomatic PLD during a more than 2-year follow-up.
The global novel drug delivery systems for cancer therapy market segmentation is based on technology types such as embolization particles, drug eluting beads, PVA particles, microspheres, gelatin-based, selective internal radiation therapy (SIRT), TheraSphere, SIR-Spheres, Holmium-based Microspheres, Liquid Embolics, Onyx (LES and HD-500), TRUFILL nBCA
LES, and nanoparticles.
To minimize premature polymerization, NBCA
should diluted with non-ionic solvent (Lipiodol) and the catheter flushed with 5% dextrose solution.
In previous reports, an absorbable gelatin sponge is a commonly used embolic material [3-5], whereas few reports have described the use of N-butyl-2-cyanoacrylate (NBCA
), which does not depend on maternal clotting factors [6, 7].
Embolization of the abnormal vessels from the ovarian artery was performed using 0.8 cc of n-butyl-2-cyanoacylate (NBCA
) lipiodol (NBCA
: lipiodol = 1:4) under arterial flow control by occlusion balloon (Figure 2(b)).
Garcarek, "Embolization of a true giant splenic artery aneurysm using NBCA
glue--Case report and literature review," Polish Journal of Radiology, vol.
Foster, supra note 127; Fash, supra note 132; Dahlnas, supra note 130; Osecap CA, supra note 129; R v Beatty, 2006 ONCJ 468, 72 WCB (2d) 76; R v Cormier, 2012 NBCA
76, 393 NBR (2d) 118; Noiles, supra note 126.