2-Hexyl cyanoacrylate (neuracryl M) embolization of cerebral arteriovenous malformations.
OBJECTIVE
Neuracryl M is a newly designed liquid embolic agent. In an attempt to verify the safety and efficacy of neuracryl M, we participated in the PROVASIS Trial, a pilot study using this agent in the preoperative treatment of cerebral arteriovenous malformations (AVMs). Because the trial was prematurely terminated by the sponsoring company because of financial considerations, we now present our data as a single center series.


METHODS
Between November 2002 and December 2003, six patients were enrolled in the PROVASIS trial at our institution, and four of these patients were randomized to treatment with neuracryl M. The patients were a 30-year-old man with a right frontal lobe AVM, a 20-year-old man with a right cerebellar AVM, a 26-year-old woman with a midline cerebellar AVM, and a 47-year-old man with a left parietotemporal lobe AVM. All patients underwent AVM embolization with neuracryl M, followed by definitive treatment, either open surgery or radiosurgery.


RESULTS
In each case, there were no permanent complications, and blood loss was minimal. Follow-up imaging demonstrated either complete AVM obliteration (open surgery) or substantial diminution in AVM size (radiosurgery).


CONCLUSIONS
Our data provide preliminary evidence supporting the thesis that neuracryl M is a safe and effective liquid embolic agent for the preoperative embolization of cerebral AVMs. Larger trials and continued experience using this novel liquid embolic agent are warranted.
Komotar
Ricardo J
RJ
Department of Neurosurgery, Columbia University, New York, New York, USA.
Ransom
Evan R
ER
Wilson
David A
DA
Connolly
E Sander
ES
Lavine
Sean D
SD
Meyers
Philip M
PM
D000328:Adult; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D003487:Cyanoacrylates; C042633:poly(hexyl-2-cyanoacrylate)