Re: Transcatheter N-butyl cyanoacrylate embolization of pseudoaneurysms.

摘要

Our division read with great interest the article by Song et al (1) published in the October issue of JVIR, reporting the effectiveness of transcatheter embolization with n-butyl cyanoacrylate (NBCA) in selected patients with peripheral arterial pseudoaneurysms (PAs). We have several comments. First of all, we would like to congratulate the authors for their study, which represents the most important series to date reporting results on transarterial embolotherapy with NBCA glue as an embolic agent in such a setting. Recently, endovascular embolization has generated considerable interest as the first-line therapeutic method for PAs. The success rate is high, ranging from 62% to 100% in visceral PAs, and the morbidity and mortality rates are low (2,3). Most investigators agree that coils are the most appropriate embolic material (3). The study of Song et al (1) shows that embolization with NBCA as the sole embolic agent is a safe and effective technique for treatment of PAs at various locations. We absolutely agree with Song et al (1) about the efficacy and safety of glue embolization of the vessel supplying the PA. We find the use of NBCA particularly interesting, especially in patients in hemodynamically unstable condition with bleeding and in cases of underlying coagulopathy, because it provides faster and better hemo-stasis than other embolic agents. In our institutionn, selective embolization with NBCA as the only embolic agent has also become the salvage treatment of choice in many visceral and peripheral indications. However, we want to stress the fact that the use of NBCA requires training and considerable experience, given the risk of bowel infarction and glue reflux into other vessels.