Cyanoacrylate embolization of experimental aneurysms.
OBJECTIVE
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).


CONCLUSIONS
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.
Raymond
Jean
J
Centre de Recherche, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, 1560 Sherbrooke Street East, Montréal, Québec, H2L 4M1 Canada.
Berthelet
France
F
Desfaits
Anne-Cécile
AC
Salazkin
Igor
I
Roy
Daniel
D
D000818:Animals; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D002533:Cerebral Angiography; D003487:Cyanoacrylates; D004195:Disease Models, Animal; D004285:Dogs; D004621:Embolization, Therapeutic / Q000379:methods*; D005240:Feasibility Studies; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome
D003487:Cyanoacrylates