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At least 19 recordsLinked to original sources
PubMed1983

Experience with bucrylate (isobutyl-2-cyanoacrylate) embolization of cerebral arteriovenous malformations during surgery.

The clinical experience with five patients selected for embolization of cerebral arteriovenous malformations with bucrylate (isobutyl-2-cyanoacrylate) during surgery is described. Bucrylate embolization was used to obliterate one arteriovenous malformation with a dominant nutrient arterial network, and to facilitate surgical resection in two other cases. The extent of the embolization in one of these cases was limited because of segmental perfusion of the AVM nidus by different nutrient arteries. Histological examination of this arteriovenous malformation, resected 56 days after embolization, suggested bucrylate has minimal histotoxicity. Two arteriovenous malformations were found at operation to be unsuitable for embolization because of technical problems with access and exposure of nutrient arteries, and also because of vagaries in the angiographic data before surgery. In two cases, rapid polymerization of bucrylate resulted in gluing of the injection catheters into the arterial lumen. Two patients experienced transient postoperative neurological deficits after bucrylate embolization. Because of the potential hazards of the technique, direct bucrylate embolization of cerebral arteriovenous malformations should only be considered for those lesions felt unsuitable for direct microsurgical excision, and where facilities exist for recording angiographic data before surgery.

Adult↗
PubMed1986

Long-term pathological follow-up of cerebral arteriovenous malformations treated by embolization with bucrylate.

We examined 17 intracranial arteriovenous malformations that were resected after treatment by embolization using bucrylate (isobutyl-2-cyanoacrylate). In nine specimens removed 5 days to 16 months after embolization therapy, a series of pathologic changes was seen, including patchy mural angionecrosis (adjacent to bucrylate fragments) up to six weeks after embolization, the presence of bucrylate in vessel walls and fibromuscular intimal cushions, and the occurrence (after several months) of entirely extravascular bucrylate. Occasional parts of recanalized vascular malformations were identified. Bucrylate was present within arteriovenous malformations as late as 16 months after embolization, although the amount appeared to be diminished. These findings suggest a specific sequence of events in the interaction between bucrylate and mural components within the malformations and may explain some important complications of embolization therapy (e.g., delayed hemorrhage after embolization).

Adolescent↗
PubMedDate not supplied

[Endoscopic obturation of esophagogastric varices with bucrylate. II. Morphologic study based on 12 autopsy cases].

The authors report the results of postmortem histopathological studies in 12 patients who had been treated by endoscopic obliteration of esophagogastric varices with Bucrylate (isobutyl-2-cyanoacrylate). All patients had cirrhosis; 11 patients were Pugh classe C. Eleven patients had esophageal injections. Acute esophageal lesions were characterized by ulcerations in obliterated varices and diffusion of Bucrylate into the esophageal wall. Chronic lesions were characterized by disappearance of varices and Bucrylate, extending fibrosis of the esophageal wall and re-epithelialization of the mucosa. In one patient who had received gastric injections only, non ulcerated Bucrylate filled gastric varices were seen. Bucrylate seems to have a dual action on esophageal varices: immediate obliteration and acute necrosis of the vascular endothelium. Necrosis causes diffusion of Bucrylate through the esophageal wall, and later, secondary fibrosis whereas the product is progressively eliminated into the esophageal lumen.

Bucrylate↗
PubMed2000

Bucrylate treatment of bleeding gastric varices: 12 years' experience.

BACKGROUND AND STUDY AIMS: For several years now there has been an increasingly widespread use of a tissue adhesive in the treatment of bleeding gastric varices to achieve rapid, safe control of hemostasis and prevent rebleeding. In this study we report on our experience with the use of Bucrylate (Hystoacryl) for the treatment of gastric varices over a period of more than a decade. PATIENTS AND METHODS: Since 1988, 174 cirrhotic patients with actively bleeding gastric varices have been admitted to our department, where they received emergency treatment with injections of Bucrylate. Any associated nonbleeding esophageal varices were subjected to traditional sclerotherapy in combination with the Bucrylate treatment. The gastric varices were subdivided into four distinct groups according to the method advocated by Sarin in 1989. The patients underwent weekly sclerotherapy sessions until their varices were eradicated, and the follow-up with a mean of 36 months (range 9-90 months) consisted of endoscopy at 3, 6, and 12 months during the first year and then yearly checks to confirm obliteration of the varices. RESULTS: The hemostasis (97.1%), early rebleeding (15.5%), and hospital mortality (19.5%) rates of the patients with bleeding gastric varices, treated with the tissue adhesive, were very similar to those of patients treated for esophageal varices over the same period (98.1%, 13.0%, and 16.4%, respectively). The most frequent cause of death at 30 days was liver failure (76% of cases), followed by hemorrhagic shock (8.8%), and other less frequent causes. Sclerotherapy achieved obliteration rate for gastric varices (70-75%) similar to that for esophageal varices in those patients with portal hypertension due to intrahepatic block (alcoholic and posthepatitis cirrhosis), but a rate of only 32% in the group of patients with prehepatic block (splenoportomesenteric thrombosis), where surgery proved more effective (69%). The medium- and long-term survival rates depended on the stability of the patients' liver conditions, on rapid, effective control of variceal hemostasis, and on complete, lasting obliteration of the gastric varices. CONCLUSIONS: The use of Bucrylate in emergency sclerotherapy achieved results in bleeding gastric varices on a par with those obtained in esophageal varices in cases of alcoholic and posthepatitis cirrhosis. The group of patients with portal hypertension due to prehepatic block (splenoportal thrombosis) showed no benefit from sclerotherapy in terms of obliteration of gastric varices, but benefited from elective surgery. The choice of the obliterating treatment indicated may be facilitated by classifying gastric varices into distinct groups on the basis of anatomicotopographic criteria.

Adolescent↗
PubMed1981

Pathology of arteriovenous malformations embolized with isobutyl-2-cyanoacrylate (bucrylate). Report of two cases.

There is controversy as to the possible toxic effects of isobutyl-2-cyanoacrylate (bucrylate) when this substance is used for purposes of therapeutic embolization. Two cases are presented in which cerebral arteriovenous malformations were resected, one 42 days and the other a year after bucrylate embolization. In both, pathological examination revealed a brisk intimal foreign-body giant-cell reaction wherever bucrylate was present in a vessel, along with chronic inflammation in the vessel walls and adjacent brain parenchyma. The findings are discussed in the light of other observations on the histotoxicity of bucrylate.

Adult↗
PubMed1985

Staining procedure to aid in assessment of bucrylate histotoxicity in tissue sections.

Isobutyl-2-cyanoacrylate (bucrylate) is commonly used as a material for therapeutic embolization. Histologic sections of embolized tissue routinely stained with hematoxylin-eosin show the bucrylate as a translucent material. We outline a staining procedure that demonstrates bucrylate in tissue sections. It is useful in routinely prepared paraffin-embedded tissue, and it is also effective after embolized tissues have been processed with petroleum ether rather than xylene. This stain may be effectively utilized to assess harmful tissue reactions to bucrylate.

Arteriovenous Malformations↗
PubMed1978

Transcatheter vascular occlusion therapy with isobutyl 2-cyanoacrylate (bucrylate) for control of massive upper-gastrointestinal bleeding.

Transcatheter embolization with bucrylate, a tissue adhesive, was performed in 16 patients with massive upper-gastrointestinal bleeding. Control of arterial bleeding from the stomach was achieved in 6 of 8 patients, and from the duodenum in 3 of 4. Embolization of gastric veins resulted in temporary control of esophageal variceal bleeding in 3 of 4 patients. Histological study showed no evidence of bucrylate causing histotoxicity in 2 patients. Because bucrylate polymerizes rapidly, a localized vascular occlusion mimicking a surgical ligation is produced. Because collateral vessels are not occluded. localized tissue ischemia is unlikely. Tissue adhesives are, however, difficult to use.

Adult↗
PubMed1979

Long-term radiographic-pathologic follow-up of patients treated with visceral transcatheter occlusion using isobutyl 2-cyanoacrylate (Bucrylate).

Visceral transcatheter occlusive therapy was performed with isobutyl 2-cyanoacrylate (Bucrylate) in 14 patients. Of 10 patients who subsequently died, postmortem examination in 6, performed 2--196 days post-embolization, showed only a mild histiocytic foreign body giant cell reaction to Bucrylate. The reaction was confined to the vessel lumina and did not involve the vessel walls or contiguous parenchymal tissues. Clinical and radiographic follow-up in the other 4 patients (range = 30--180 days) showed no evidence of untoward reaction to Bucrylate. No ischemic or inflammatory complications were observed in any of the peripheral organs.

Adult↗
PubMed1980

Transcatheter embolization of the renal artery with bucrylate in renal carcinoma.

In 5 patients with large renal carcinomas Bucrylate was injected into the renal artery. One to 3.5 ml Bucrylate were required to obtain occlusion of the arteries. At operation 14 to 38 days later the arteries were still occluded. One patient developed pulmonary embolism, other complications were of less importance. The main indication for the procedure is very large, highly vascularized carcinomas in the upper part of the kidney. Bucrylate seems to be a suitable embolus inducing agent.

Aged↗
PubMed1979

Transcatheter occlusive therapy of genitourinary abnormalities using isobutyl 2-cyanoacrylate (Bucrylate).

Transcatheter occlusive therapy was performed with isobutyl 2-cyanoacrylate (Bucrylate) in 14 patients with a variety of genitourinary abnormalities. Bucrylate was found to be a valuable agent when used to: (1) occlude vessels with very slow flow; (2) occlude vessels in patients with coagulopathies; (3) occlude high flow arteriovenous fistulas; (4) perform superselective vessel occlusion; and (5) produce permanent vessel obliteration. Bucrylate was used effectively in this group of patients and was used without complications or evidence of histotoxicity.

Adult↗
PubMed1982

Embolization of cerebral arteriovenous malformations with bucrylate.

Forty-six patients with cerebral arteriovenous malformations (AVM's) were selected for embolization with bucrylate. These patients were assigned to three different groups. Group I consisted of 22 patients with nonresectable AVM's who were selected for embolization with a Silastic calibrated-leak ballon. In 16 or these patients, embolization was achieved, with partial obliteration of the AVM in 14 and complete obliteration in two. Five patients had subarachnoid hemorrhage caused by the balloon bursting and concomitant dissection of the feeding vessel. Four of these patients recovered completely and one died of a brain-stem hemorrhage. A permanent field defect was noted in five cases, and two patients had a transient mild neurological deficit. Group II consisted of 13 patients treated by intraoperative embolization. Complete obliteration by embolization was obtained in four cases, and complete surgical resection after embolization in five. Partial embolization with no surgical resection was achieved in five cases. Three of these patients had a permanent mild neurological deficit and two had transient deficits. There was no mortality in this group. Group III consisted of 11 patients treated by embolization with bucrylate using a new latex calibrated-leak balloon. This balloon has a higher malleability, and takes on the exact configuration of the feeder, with no risk of dissection. This balloon also permits delivery of the faster and larger injection of bucrylate to the arterial feeders of the AVM. Two AVM's were completely obliterated, and embolization was only partially successful in the other cases. Neurological complications consisted of incomplete field defects in two cases, slight memory loss in one case, and transient clumsiness of the arm and face in one case. Two patients have a catheter permanently glued in the malformation, with no neurological complication. There was no mortality in this group.

Adolescent↗
PubMed1994

High flow priapism after blunt perineal trauma: resolution with bucrylate embolization.

We report on 2 patients (ages 21 and 33 years) with high flow priapism secondary to arteriocavernous fistula produced by perineal injury. Both cases were satisfactorily resolved by super-selective embolization of the fistula with bucrylate. Diagnosis was based on the results of gasometry in cavernous blood, color Doppler ultrasound and arteriography. Erectile function after 24 and 30 months of treatment, respectively, was normal in both patients. Review of the literature revealed that only 13 patients have been managed with arterial embolization. To our knowledge our report represents the first in which intracavernous bucrylate embolization produced detumescence with preservation of erectile function.

Adult↗
PubMed1978

Isobutyl 2-cyanoacrylate (bucrylate) in obliteration of gastric coronary vein and esophageal varices.

Percutaneous transhepatic portography was performed in 22 patients with liver cirrhosis and portal hypertension. All patients had bled or were bleeding from presumed esophageal varices. One or more veins feeding esophageal varices were occluded with bucrylate. Follow-up examination in eight patients 1-12 months later showed recanalization of previously obliterated veins in six; however, these veins were markedly smaller than before the procedure. In patients where veins were still occluded, new veins had opened up and carried blood to the esophageal varices, which were filled to a lesser degree than before. In our experience, bucrylate is superior to Gelfoam, thrombin, and Etolein in producing venous occlusion.

Adult↗
PubMed1980

Bucrylate embolization of abdominal aortic aneurysms: an adjunct to nonresective therapy.

Abdominal aneurysmectomy in a patient with an abdominal aortic aneurysm who has cardiac, renal, or pulmonary disease is associated with a high surgical mortality. Fifteen such patients underwent nonresective therapy of an abdominal aortic aneurysm consisting of an axillobifemoral bypass graft which maintains blood flow to the lower extremities. At the time of the graft the iliac vessels were ligated, occluding the outflow tract from the aneurysm, and resulting in retrograde thrombosis. In three of the 15 patients, however, the aneurysm remained patent because of patency of the hypogastric arteries. The outflow tract in these three patients was occluded by a transcatheter injection of Bucrylate, a tissue adhesive, into the distal abdominal aorta and iliac vessels. Bucrylate embolization is a potentially useful adjunct to nonresective treatment of abdominal aortic aneurysms.

Aged↗
PubMed1979

Forums in gastrointestinal roentgenology: transhepatic portal venography and selective obliteration of gastroesophageal varices using isobutyl 2-cyanoacrylate (bucrylate).

Five patients with Child's class C alcoholic cirrhosis and actively bleeding gastroesophageal varices underwent transhepatic portal venography and selective obliteration of varices with isobutyl 2-cyanoacrylate (Bucrylate). Temporary control of bleeding was obtained in four patients and complete control in one. This new technique is best utilized to stop active variceal hemorrhage in patients who are not candidates for portasystemic shunt surgery or to control bleeding while the patient's general medical condition is improved to decrease the risk of subsequent shunt surgery.

Bucrylate↗
PubMed1983

Occlusion of a hepatic artery to portal vein fistula with bucrylate.

A 49-year-old woman with cirrhosis and portal hypertension was evaluated for a portal-systemic shunt procedure following recurrent variceal hemorrhage. The preoperative visceral angiogram demonstrated a hepatic arterial to portal venous fistula, presumably a complication of a previous liver biopsy. The fistula was successfully closed using isobutyl-2-cyanoacrylate (Bucrylate) delivered through a flow-directed, calibrated-leak balloon microcatheter.

Angiography↗
PubMed1985

Factors affecting the probability of conception after treatment of subfertile men with varicocele by transcatheter embolization with Bucrylate.

Retrospective analysis of 100 patients treated for varicocele-associated infertility by means of transcatheter embolization with 2-isobutyl-cyano acrylate (Bucrylate, Ethicon Inc., Somerville, NJ) reveals that the age of the man and the duration of infertility do not influence the probability of pregnancy after treatment. Patients treated for subclinical varicoceles had the same probability of success as patients with larger varicoceles. The following factors were found to have predictive power as far as the posttreatment success rate is concerned: the coincidence of other disease interfering with the fertility of the man or woman, serum follicle-stimulating hormone concentration, total testicular volume, and pretreatment semen quality. Depending on the latter factors, the probability of conception varies between 8% and 80%. It seems possible to define certain subgroups of varicocele patients with poor, moderate, or good fertility prognosis.

Bucrylate↗