Osanai Toshiya, Asano Takeshi, Terasaka Shunsuke, Houkin Kiyohiro
Department of Neurosurgery, Hokkaido University, Japan.
No Shinkei Geka. 2012 Jul;40(7):599-606.
Preoperative embolization for hypervascular tumors is typically performed using particle agents such as polyvinyl alcohol, gelfoam powder, and fibrin glue. Furthermore, n-butyl-2-cyanoacrylate (NBCA) is used in patients with cerebral arteriovenous malformation (AVM) or an AV shunt. However, few reports have described the efficacy of NBCA in treating hypervascular tumors. Here, we report cases of hypervascular tumors in which preoperative embolization was performed using NBCA. We also discuss the difference between the efficacy of a liquid agent and a particle agent for hypervascular tumor embolization. We analyzed 10 cases encountered at our institution since 2004 in which preoperative embolization was performed using NBCA. In all cases, NBCA was injected through the tumor-feeding artery. In eight of these cases, preoperative embolization decreased intraoperative bleeding and markedly reduced the tumor stain. In the remaining two cases, complications occurred but without any permanent sequel. Thus, NBCA is useful for preoperative embolization.
对于富血管肿瘤的术前栓塞,通常使用聚乙烯醇、明胶海绵粉和纤维蛋白胶等颗粒剂。此外,正丁基-2-氰基丙烯酸酯(NBCA)用于患有脑动静脉畸形(AVM)或动静脉分流的患者。然而,很少有报告描述NBCA治疗富血管肿瘤的疗效。在此,我们报告使用NBCA进行术前栓塞的富血管肿瘤病例。我们还讨论了液体剂和颗粒剂在富血管肿瘤栓塞疗效方面的差异。我们分析了自2004年以来在我们机构遇到的10例使用NBCA进行术前栓塞的病例。在所有病例中,NBCA均通过肿瘤供血动脉注入。其中8例病例中,术前栓塞减少了术中出血并显著减少了肿瘤染色。在其余2例病例中,发生了并发症,但没有任何永久性后遗症。因此,NBCA对于术前栓塞是有用的。