Feasibility of the Glue-in-Plug Technique Using a Novel Liquid Embolic Material in a Swine Model

Purpose: To evaluate the feasibility of the glue-in-plug (GIP) technique using n-butyl-2-cyanoacrylate-Lipiodol (NL)- iopamidol (NLI) for short-segment embolization in swine.Materials and Methods: The renal arteries, left external iliac artery, subclavian arteries, and common carotid arteries were each embolized in 4 swine using the GIP technique under general anesthesia. First, a type I Amplatzer vascular plug (AVP) (1-2 times the target vessel diameter) was deployed in the target artery. Next, the AVP was filled with NL mixture prepared at a ratio of 1:2 (NL12) (n = 11) or with NLI mixture prepared at a ratio of 2:3:1 (NLI231) (n = 11). Angiography was performed before, immediately after, and 1 hour after embolization to assess embolization and migration of the embolic materials. The embolized arteries were also evaluated histopathologically.Results: The migration distance of the embolic material beyond the plug tip was significantly shorter in the NLI231 group than in the NL12 group immediately after embolization (6.5 mm +/- 4.5 vs 1.0 mm +/- 1.8, P = .0024) and 1 hour after embolization (8.4 mm +/- 5.6 vs 1.0 mm +/- 1.8, P = .0013). Angiography revealed no sign of recanalization of the target vessels in any artery in either group. Mild inflammatory cell infiltration was observed around the arterial wall at the embolization site in all arteries in both groups.Conclusions: The GIP technique using NLI231 may be a feasible procedure for short-segment embolization based on these short-term results.