Transcatheter embolization with bucrylate (in 100 patients)

Abstract

Since 1974 we have been investigating the role of transcatheter embolization with bucrylate. During this period of time we have learned a great deal about the use of bucrylate for such purposes. Because of its unique properties, which can be varied to some degree by angiographic techniques, the tissue adhesive can be used successfully as an embolic material in a wide spectrum of difficult clinical situations. The material, however, is not easy to use and we have experienced some complications in its use. In order to minimize these complications, one must have knowledge of the inherent risks when one embolizes a particular region. In the stomach, one must be concerned with infarction; in arteriovenous malformations, with pulmonary embolization, and in the spleen, with the development of an abscess (Drawing 6). [See figure in the PDF file] Control of the embolization procedure is crucial to a successful outcome. This control can be achieved by: A. Selective catheter positioning. B. Opacification of the tissue adhesive. C. Fine fluoroscopic imaging. D. Control over the distribution of the bucrylate within the embolized region (Figure 2). 1 . Coaxial Catheter System. a. Balloon occlusion. b. Straight coaxial. 2. Control of the polymerization rate of the bucrylate. a. Tantalum powder. b. Ethiodol or Pantopaque. One must always be aware, however, that the decision to undertake an embolization procedure should not be taken lightly. It is best determined by a team consisting of a surgeon, internist, angiographer and whenever possible, the patient and/or his family.