Efficacy and low vascular toxicity of embolization with radical versus anionic polymerization of n-butyl-2-cyanoacrylate (NBCA). An experimental study in the swine.
OBJECTIVE
To compare the efficacy and vascular toxicity of embolization with radical (NBCA+metacryloxysulpholane=CS) versus conventional anionic (NBCA alone=CA) polymerization of NBCA.


METHODS
Under continuous digital subtracted angiography (DSA) recordings, a 0.2 mL volume of identical glue mixtures were injected in a single-step procedure, concomitantly, in left and right (with CS and CA, respectively) renal arterial branches (RAB) and ascending pharyngeal arteries (APA) in 8 swines. Arterial histopathology and morphometry of inflammation were investigated at 2 weeks.


RESULTS
Complete embolization was achieved with equivalent cast homogeneity on DSA with both NBCA mixtures in RAB and APA. Inflammatory crowns in APA and RAB were significantly lower in CS - than in CA-treated sites (p<0.001). CS plug was scarcely adhesive to the vascular wall, and pulled apart from the wall by a residual thrombotic lining; in contrast with CA casts that were strongly adhesive to walls with endothelium stripping.


CONCLUSIONS
Anionic and radical polymerization of NBCA embolization was identical with regards to occlusion rate; whereas radical pathway of polymerization with cyanoacrylates lowered histotoxicity with a less sustained adhesiveness of casts against vascular walls.
Levrier
O
O
Laboratoire d'Hémodynamique et de Mécanique Cardiovasculaire, Faculté de Médecine Marseille, Hôpital de La Timone, France. olevrier@mail.ap-hm.fr
Mekkaoui
C
C
Rolland
P H
PH
Murphy
K
K
Cabrol
P
P
Moulin
G
G
Bartoli
J M
JM
Raybaud
C
C
D015901:Angiography, Digital Subtraction; D000818:Animals; D001167:Arteritis / Q000473:pathology; D003487:Cyanoacrylates / Q000633:toxicity*; D004621:Embolization, Therapeutic / Q000379:methods*; D004659:Enbucrilate / Q000633:toxicity*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D005549:Foreign-Body Reaction / Q000473:pathology; D008297:Male; D011108:Polymers; D013329:Structure-Activity Relationship; D013552:Swine
D003487:Cyanoacrylates; D011108:Polymers; C421461:glubran 2; D004659:Enbucrilate