关键词: animal cyanoacrylate embolization iodinated contrast agent lipiodol

来  源:   DOI:10.3390/biomedicines11123177   PDF(Pubmed)

Abstract:
N-butyl cyanoacrylate (NBCA) is a lipophilic, permanent embolic glue that must be opacified for fluoroscopic guidance. Empirically, lipophilic Lipiodol Ultra Fluid® (LUF) has been added to produce a single-phase physically stable mixture. Varying the dilution ratio allows control of glue polymerization kinetics. LUF is far more costly than water-soluble iodinated contrast agents (ICAs). Our purpose was to evaluate whether a water-soluble nonionic iso-osmolar ICA could be used instead. We embolized both renal arteries of six swine using 1:3 NBCA-LUF or NBCA-iodixanol in 1:1, 1:3, and 1:7 ratios. We used both micro-computed tomography to assess the distality of glue penetration and indexed cast ratio and histology to assess distality, arterial obliteration, vessel-wall damage, and renal-parenchyma necrosis. Glue-LUF produced significantly greater indexed cast ratio and renal-artery ROI values and a significantly shorter cast-to-capsule distance. The injected volume was significantly greater with 1:7 iodixanol than with the other mixtures. No significant differences were found for histological evidence of artery obliteration, vessel-wall damage, or renal-parenchyma necrosis. This is the first study dealing with ICA alone as a contrast agent for cyanoacrylate embolization, compared to LUF. More research is needed to determine whether water-soluble nonionic iodinated agents can be used for human NBCA embolization given the good safety profile, availability, and low cost of ICA.
摘要:
氰基丙烯酸正丁酯(NBCA)是一种亲脂性,永久性栓塞胶,必须不透明以进行透视引导。根据经验,添加亲脂性碘油UltraFluid®(LUF)以产生单相物理稳定的混合物。改变稀释比允许控制胶聚合动力学。LUF比水溶性碘化造影剂(ICAs)昂贵得多。我们的目的是评估是否可以使用水溶性非离子等渗ICA。我们使用1:3的NBCA-LUF或NBCA-碘克沙醇以1:1、1:3和1:7的比例栓塞了六只猪的两个肾动脉。我们使用了显微计算机断层扫描来评估胶水渗透的远距和索引铸造率,以及组织学来评估远距,动脉闭塞,血管壁损伤,肾实质坏死.Glue-LUF产生了显着更高的索引铸型比和肾动脉ROI值,并显着缩短了铸型到胶囊的距离。1:7碘克沙醇的注入体积明显大于其他混合物。动脉闭塞的组织学证据没有发现显着差异,血管壁损伤,或肾实质坏死。这是第一项单独使用ICA作为氰基丙烯酸酯栓塞的造影剂的研究,与LUF相比。鉴于良好的安全性,需要更多的研究来确定水溶性非离子碘化剂是否可用于人类NBCA栓塞,可用性,和低成本的ICA。
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