title: Compliant neurovascular balloon catheters may not be compatible with liquid embolic materials: intraprocedural rupture of the protecting balloon during tumor embolization using n-butyl cyanoacrylate and lipiodol mixture.
abstract: BACKGROUND
  Simultaneous use of balloon catheters with embolic materials can cause unwanted rupture of the balloon occlusion catheters, which might cause a serious problem. Therefore, knowledge of the compatibility of occlusion balloon catheters with liquid embolic materials is important in various interventional procedures.
  
  
  OBJECTIVE
  To determine the compatibility of occlusion balloon catheters with commonly used embolic materials in vitro.
  
  
  METHODS
  We used three types of occlusion balloon catheters (Scepter C, Microvention, Tustin, California, USA; Hyperform, Covidien, Irvine, California, USA; and Ascent, Codman Neurovascular, Raynham, Massachusetts, USA) to test their tolerances to Lipiodol, n-butyl cyanoacrylate (NBCA; Histoacryl; B Braun, Melsungen, Germany), and dimethyl sulfoxide (DMSO) with Onyx. The balloon was inflated just as it is in an endovascular procedure, then put on a Petri dish to observe its morphological change after one drop of liquid embolic material was added using a 1 mL syringe. The presence of rupture and the time to rupture were evaluated by constant video monitoring. Additionally, we observed morphological changes of the balloon catheter surface after contact with embolic materials with a scanning electron microscope.
  
  
  RESULTS
  Lipiodol or a 33% NBCA-Lipiodol mixture dropping onto the three types of balloon catheter resulted in ruptures of all three. All three types of balloon catheter were tolerant to NBCA and to DMSO followed by Onyx.
  
  
  CONCLUSIONS
  Glue embolization should not be performed with all three kinds of balloon catheter on the market, but DMSO and Onyx are compatible with those balloon catheters.
authors.affiliation: Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Soonchan
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Seon Moon
authors.initials: SM
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Ok Kyun
authors.initials: OK
authors.lastname: Lim
authors.affiliation: Biomedical R&D Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea.
authors.forename: Changmo
authors.initials: C
authors.lastname: Hwang
authors.affiliation: Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Deok Hee
authors.initials: DH
authors.lastname: Lee
mesh_terms: D000970:Antineoplastic Agents; D021721:Balloon Occlusion / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D001932:Brain Neoplasms / Q000098:blood supply / Q000628:therapy*; D057785:Catheters / Q000592:standards*; D016461:Chemoembolization, Therapeutic / Q000379:methods / Q000592:standards*; D004121:Dimethyl Sulfoxide; D004659:Enbucrilate; D004868:Equipment Failure; D004998:Ethiodized Oil; D006391:Hemangioma / Q000098:blood supply / Q000628:therapy*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls; D012997:Solvents
chemical_list: D000970:Antineoplastic Agents; C450660:Onyx copolymer; D011145:Polyvinyls; D012997:Solvents; D004998:Ethiodized Oil; D004659:Enbucrilate; D004121:Dimethyl Sulfoxide
keywords: Balloon; Catheter; Liquid Embolic Material; Tumor