Miyake Yuichi, Yonemitsu Takafumi, Shima Nozomu, Fukuda Kodai, Fukui Tomoya, Shibata Naoaki, Ikoma Akira, Inoue Shigeaki, Sonomura Tetsuo
Department of Radiology, Wakayama Medical University, Japan.
Department of Emergency and Critical Care Medicine, Wakayama Medical University, Japan.
Interv Radiol (Higashimatsuyama). 2025 Jun 13;10:e20240068. doi: 10.22575/interventionalradiology.2024-0068. eCollection 2025.
-butyl cyanoacrylate is a liquid embolic material used to treat bleeding. Rebleeding may occur after -butyl cyanoacrylate embolization due to vasospasm and dilation of the embolized artery. However, the impact of vasospasm on -butyl cyanoacrylate embolization has not been fully investigated. Therefore, we investigated the impact of vasospasm on the effects of -butyl cyanoacrylate embolization in swine arteries.
Using a swine bleeding model, 24 arteries (hepatic/splenic/both renal/cranial mesenteric) in 5 swine were divided into vasoactive and control groups. The recanalization rates after embolization with 20% -butyl cyanoacrylate and the volume of -butyl cyanoacrylate used for embolization were compared between the 2 groups. Arteries in the vasoactive group were constricted by constant venous infusion of vasopressin and an arterial injection of noradrenaline just before embolization and then dilated by arterial injection of papaverine and lidocaine immediately after embolization. Angiography was performed to evaluate recanalization of the embolized arteries immediately and at 5, 15, 30, 45, and 60 minutes after embolization. Recanalization was defined as complete recanalization within 60 minutes or partial recanalization at 60 minutes.
Angiography revealed recanalization in a significantly greater proportion of arteries in the vasospasm group (11/12 arteries [91.7%]) than in the control group (2/12 arteries [16.7%]) (p = 0.0006). The median volume of -butyl cyanoacrylate used during embolization was significantly lower in the vasoactive group (0.32 mL) than in the control group (0.78 mL) (p = 0.0037).
Vasospasm during -butyl cyanoacrylate embolization increased the recanalization rate of the embolized arteries and reduced the embolization effect in swine.
氰基丙烯酸正丁酯是一种用于治疗出血的液体栓塞材料。氰基丙烯酸正丁酯栓塞后，由于血管痉挛和栓塞动脉扩张，可能会发生再出血。然而，血管痉挛对氰基丙烯酸正丁酯栓塞的影响尚未得到充分研究。因此，我们研究了血管痉挛对猪动脉中氰基丙烯酸正丁酯栓塞效果的影响。
使用猪出血模型，将5头猪的24条动脉（肝/脾/双侧肾/肠系膜上动脉）分为血管活性组和对照组。比较两组用20%氰基丙烯酸正丁酯栓塞后的再通率以及用于栓塞的氰基丙烯酸正丁酯体积。血管活性组的动脉在栓塞前通过持续静脉输注血管加压素和动脉注射去甲肾上腺素使其收缩，然后在栓塞后立即通过动脉注射罂粟碱和利多卡因使其扩张。在栓塞后即刻以及5、15、30、45和60分钟进行血管造影，以评估栓塞动脉的再通情况。再通定义为60分钟内完全再通或60分钟时部分再通。
血管造影显示，血管痉挛组动脉再通的比例（12条动脉中的11条[91.7%]）显著高于对照组（12条动脉中的2条[16.7%]）（p = 0.0006）。血管活性组栓塞期间使用的氰基丙烯酸正丁酯的中位体积（0.32 mL）显著低于对照组（0.78 mL）（p = 0.0037）。
氰基丙烯酸正丁酯栓塞期间的血管痉挛增加了猪栓塞动脉的再通率，并降低了栓塞效果。
