Kim Jinoo, Shin Ji Hoon, Yoon Hyun-Ki, Ko Gi-Young, Gwon Dong Il, Kim Eun-Young, Sung Kyu-Bo
Department of Radiology, Hanyang University, College of Medicine, Hanyang University Guri Hospital, Gyeonggi-do, Seoul, Korea.
Acta Radiol. 2012 May 1;53(4):415-21. doi: 10.1258/ar.2012.110595. Epub 2012 Mar 8.
Despite its long history, the application of N-butyl cyanoacrylate (NBCA) has been limited compared to other materials such as particulate agents and coils. This possibly owes to a widespread misconception that NBCA is difficult to handle and carries a high risk of complications due to its liquid nature and rapid polymerization time. However, recent reports have shown that, with knowledge and experience, NBCA is safe and effective to use in visceral arteries.
To review the outcome of transcatheter embolization of the renal artery using NBCA for varied etiologies in the kidney.
Fourteen patients with varied etiologies in the kidney underwent renal artery embolization using NBCA as the sole embolic agent (64%) or in combination with an additional embolic material (36%). A review of medical charts and images were performed to gather information regarding underlying etiologies, clinical presentation, and outcome of embolization.
Technical success was achieved in all patients (100%) while clinical success was achieved in 12 (85.7%). One failed case was managed by repeat embolization using microcoils, while the other underwent partial nephrectomy after failed reattempt at embolization. Three patients with recurrent bleeding after previously having undergone embolization using microcoils or gelatin sponge particles were successfully managed the second time using NBCA. NBCA embolization was also effective in three patients with hemostatic abnormality. Complications attributable to NBCA embolization were renal atrophy in one patient and microcatheter tip fracture in another.
The application of NBCA for transcatheter embolization of varied etiologies involving the renal artery is feasible and safe in the hands of an experienced interventional radiologist. It offers immediate and effective occlusion of the pathologic vessel and, while it can be used exclusively on its own, it can also be used to complement other embolic materials.
尽管氰基丙烯酸正丁酯（NBCA）应用历史悠久，但与颗粒剂和弹簧圈等其他材料相比，其应用一直受到限制。这可能归因于一种普遍的误解，即由于NBCA为液体性质且聚合时间短，难以操作且并发症风险高。然而，最近的报告显示，有了相关知识和经验后，NBCA在内脏动脉中使用是安全有效的。
回顾使用NBCA对各种病因的肾动脉进行经导管栓塞的结果。
14例各种病因的肾病患者接受了肾动脉栓塞治疗，其中64%仅使用NBCA作为栓塞剂，36%联合使用其他栓塞材料。回顾病历和影像资料，收集有关潜在病因、临床表现和栓塞结果的信息。
所有患者均取得技术成功（100%），12例取得临床成功（85.7%）。1例失败病例通过使用微弹簧圈重复栓塞处理，另1例在栓塞再次失败后接受了部分肾切除术。3例先前使用微弹簧圈或明胶海绵颗粒栓塞后复发出血的患者，第二次使用NBCA成功处理。NBCA栓塞对3例止血异常患者也有效。NBCA栓塞引起的并发症包括1例肾萎缩和1例微导管尖端断裂。
在经验丰富的介入放射科医生手中，将NBCA应用于各种病因的肾动脉经导管栓塞是可行且安全的。它能立即有效地闭塞病变血管，既可以单独使用，也可以与其他栓塞材料联合使用。
