title: Effect of glacial acetic acid and ethiodized oil concentration on embolization with N-butyl 2-cyanoacrylate: an in vivo investigation.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  Predictable control of the embolization process with N-BCA in vivo is attained by varying the amount of GAA in the embolic mixture.
authors.affiliation: Department of Biomedical Engineering, University of Miami, Miami, FL, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gounis
authors.forename: Baruch B
authors.initials: BB
authors.lastname: Lieber
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Wakhloo
authors.forename: Ralf
authors.initials: R
authors.lastname: Siekmann
authors.forename: L N
authors.initials: LN
authors.lastname: Hopkins
mesh_terms: D019342:Acetic Acid / Q000627:therapeutic use*; D015901:Angiography, Digital Subtraction; D000818:Animals; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000627:therapeutic use*; D004998:Ethiodized Oil / Q000627:therapeutic use*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008955:Models, Cardiovascular; D009994:Osmolar Concentration; D011817:Rabbits; D012039:Regional Blood Flow; D013348:Subclavian Artery / Q000000981:diagnostic imaging / Q000503:physiopathology
chemical_list: D004998:Ethiodized Oil; D004659:Enbucrilate; D019342:Acetic Acid