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

为了建立线圈辅助n -丁基-2-氰基丙烯酸酯（NBCA）栓塞技术的方法学并评估其可行性，以3头猪的38条动脉为靶动脉进行了栓塞。在一半的目标动脉中放置单个锚定线圈（a组；n=19）。其余采用线圈中线圈技术制成的线圈混合物（B组，n=19）。在两组中，在线圈放置后，通过微导管注射50% nbca -脂醇混合物（50% nbca），评估铸型在线圈块上形成的长度（bbb10 1cm）和铸型碎片。结果，所有动脉在栓塞后立即闭塞。B组（11/19）比A组（4/19）更频繁地出现线圈置入后的血流延迟（p=0.0448）。B组（分别为3/19和4/19）比A组（分别为9/19和7/19）更少观察到线圈团上的铸件形成和铸件破碎（p=0.0463和0.0489）。与血流延迟的动脉（13/23）相比（p=0.0021），线圈肿块上方的铸型形成发生率较低（1/15）。血流延迟的动脉未发生铸型碎裂（p<0.001）。从这些结果中，我们得出结论，如果线圈引起足够的血流延迟，线圈辅助NBCA栓塞技术在短段靶血管栓塞是可行的。建议采用线圈中线圈技术来提高流动延迟。

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.