Establishment of coil-assisted NBCA embolization technique-Toward the standardization of vascular embolization

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To establish the methodology and assess feasibility of coil-assisted N-butyl-2-cyanoacrylate (NBCA) embolization technique, thirty-eight arteries of three swine were embolized as target arteries.In half of the target arteries, a single anchoring coil was placed (Group A; n=19). In the remaining, a coil mixture made by coil-in-coil technique was used(Group B; n=19). In both groups, 50% NBCA-lipiodol mixture (50%NBCA) was injected via microcatheter Flow delay after coil placement, the length of cast formation over the coil mass(＞1cm) and cast fragmentation were evaluated.As a result, all arteries occluded just after embolization. Flow delay after coil placement occurred more frequently in Group B (11/19) than in Group A (4/19) (p=0.0448). Cast formation over the coil mass and cast fragmentation were observed less frequently in Group B (3/19 and 4/19, respectively) than in Group A (9/19 and 7/19, respectively) (p=0.0463 and 0.0489). Cast formation over the coil mass occurred less frequently in the arteries with flow delay (1/15), compared to their counterparts (13/23) (p=0.0021).Cast fragmentation did not occur in any artery with flow delay (p＜0.001).From these results, we concluded that coil-assisted NBCA embolization technique is feasible for embolization in short segment of target vessels, if the coil induces a sufficient flow delay. Coil-in-coil technique is recommended to enhance flow delay.