Low Morbidity Associated With the Use of Nbca Liquid Adhesive for Preoperative Transarterial Embolization of Central Nervous System Tumors

Author:

Kim Louis J.1,Albuquerque Felipe C.1,Aziz-Sultan Ali1,Spetzler Robert F.1,McDougall Cameron G.1

Affiliation:

1. Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, Department of Neurological Surgery, University of Miami School of Medicine, Miami, Florida

Abstract

Abstract OBJECTIVE To determine the safety and efficacy of preoperative embolization of central nervous system (CNS) tumors with n-butyl cyanoacrylate (NBCA) liquid adhesive. METHODS Over a 6-yr period, 35 consecutive patients (12 women, 23 men; mean age, 42 yr; range, 6 mo to 75 yr) with a CNS tumor underwent preoperative embolization with NBCA. Tumor type, location, endovascular and surgical treatment, percent of tumor embolization, estimated blood loss, and neurological deficits related to embolization were evaluated retrospectively. RESULTS One hundred feeding arteries were embolized (mean, 3 vessels/patient). In only one case (3%) a normal artery was inadvertently occluded by the embolization. During follow-up the resulting neurological deficit resolved completely. There were no neurological deficits or inadvertent embolization events in the remaining 34 cases. The mean percent of tumor embolized was 68%, but did not significantly correlate with operative blood loss (Pearson's correlation coefficient, r = 0.049). CONCLUSION In experienced hands, CNS tumors can be embolized with NBCA liquid adhesive with a high degree of safety and efficacy. We believe that adroit embolization technique with NBCA and other embolisates should be part of the contemporary neuroendovascular armamentarium.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical),Surgery

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