Yamakado K, Nakatsuka A, Tanaka N, Takano K, Matsumura K, Takeda K
Department of Radiology, Mie University School of Medicine, Tsu, Japan.
J Vasc Interv Radiol. 2000 Jan;11(1):66-72. doi: 10.1016/s1051-0443(07)61284-6.
To evaluate the clinical efficacy of transcatheter arterial embolization with n-butyl cyanoacrylate (NBCA) for ruptured pseudoaneurysms, which are difficult to control by coil embolization alone.
Ruptured pseudoaneurysms developed at the celiac trunk (n = 1), gastroduodenal artery (n = 2), pancreatic arcade (n = 1), hepatic artery (n = 3), renal artery (n = 1), and intercostal artery (n = 1) in nine patients. NBCA was mixed with iodized-oil (1:2) and injected via the 3-F microcatheter under fluoroscopic guidance, after the catheter was advanced close to the pseudoaneurysm. Coil embolization was performed to control blood flow before administration of NBCA in seven patients. NBCA was injected immediately after coil embolization in four patients. Embolization with NBCA was performed for recurrent bleeding that occurred within 1-21 days (mean, 10.7 days) after initial coil embolization in three patients. Two patients with peripheral pseudoaneurysms underwent embolization with NBCA alone.
The NBCA mixture was visible under fluoroscopy, and was useful in monitoring the embolization process and deciding the endpoint. Embolization was technically successful without major complications in all patients. Pseudoaneurysms and afferent and efferent arteries were eliminated immediately after embolization. Bleeding was stopped after embolization in all cases. Rebleeding did not occur in any patient during their follow-up periods of 0.7-69.5 months (mean, 17.9 months).
Embolization with NBCA is a feasible and useful treatment for ruptured pseudoaneurysms, which are difficult to control by coil embolization alone.
评估使用氰基丙烯酸正丁酯（NBCA）经导管动脉栓塞术治疗单纯弹簧圈栓塞难以控制的破裂假性动脉瘤的临床疗效。
9例患者的腹腔干（1例）、胃十二指肠动脉（2例）、胰周动脉弓（1例）、肝动脉（3例）、肾动脉（1例）和肋间动脉（1例）发生破裂假性动脉瘤。在将导管推进至靠近假性动脉瘤后，将NBCA与碘化油按1:2混合，在透视引导下经3F微导管注入。7例患者在注入NBCA前进行弹簧圈栓塞以控制血流。4例患者在弹簧圈栓塞后立即注入NBCA。3例患者在初次弹簧圈栓塞后1 - 21天（平均10.7天）内发生复发性出血，使用NBCA进行栓塞。2例周围性假性动脉瘤患者仅接受了NBCA栓塞。
NBCA混合物在透视下可见，有助于监测栓塞过程并确定终点。所有患者栓塞技术均成功，无重大并发症。栓塞后假性动脉瘤及供血动脉和引流动脉立即消失。所有病例栓塞后出血均停止。所有患者在0.7 - 69.5个月（平均17.9个月）的随访期内均未发生再出血。
对于单纯弹簧圈栓塞难以控制的破裂假性动脉瘤，NBCA栓塞是一种可行且有效的治疗方法。
