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Use of N-butyl 2-cyanoacrylate (nBCA) for preoperative tumor embolization

Use of N-butyl 2-cyanoacrylate (nBCA) for preoperative tumor embolization

Authors :
Dossani, Rimal H
Waqas, Muhammad
Rai, Hamid H
Baig, Ammad A
Cappuzzo, Justin M
Siddiqui, Adnan H
Levy, Elad I
Source :
Journal of Neurointerventional Surgery; 2022, Vol. 14 Issue: 1 pneurintsur-neurintsur
Publication Year :
2022

Abstract

N-butyl 2-cyanoacrylate (nBCA) is a fast-acting liquid adhesive that polymerizes when it comes in contact with blood anions. We present the principles of nBCA preparation and delivery for tumor embolization of a right convexity meningioma in a patient who presented with a 6-month history of word-finding difficulty and memory loss video 1. Angiography of the middle meningeal artery showed a hairpin turn that was not negotiable with a number of different microwires, including the Synchro-2, Chikai 014 and Balt hybrid 008 wire. Due to the tortuous hairpin turn, the microcatheter position was distal to the tumor blush for the convexity meningioma. Given the distal microcatheter position, we opted for nBCA as the liquid embolic of choice for tumor embolization. The time of polymerization for nBCA may be delayed using glacial acetic acid, which makes nBCA ideal when the microcatheter is in a distal position relative to the target location for embolization. The patient underwent successful embolization using nBCA and was taken for a right frontal craniotomy for resection of the meningioma the next day. The intraoperative blood loss was 100 mL and the postoperative MRI showed gross total resection. The patient had an uncomplicated hospital course and was discharged home on post-procedure day 3.[Figure]

Details

Language :
English
ISSN :
17598478 and 17598486
Volume :
14
Issue :
1
Database :
Supplemental Index
Journal :
Journal of Neurointerventional Surgery
Publication Type :
Periodical
Accession number :
ejs58705982
Full Text :
https://doi.org/10.1136/neurintsurg-2021-017400