Search

• Intracranial hemangioblastoma embolization holds promising results. • Intraoperative blood loss was estimated as 464.29 ml (95% CI: 350.63 ml–614.8 ml). • Major complications occurred in 1% (95% CI: 0% to 3%) of patients. • Minor complications in 1% (95% CI: 0% to 4%) of patients. • Further research is needed to confirm its long-term effectiveness and safety. Hemangioblastomas (HBs) are highly vascular tumors linked to substantial morbidity and mortality. Recently, interventional neuroradiology has evolved rapidly, spurring interest in preoperative embolization as a possible HB treatment. This study evaluates the effectiveness and safety of preoperative embolization in managing HB. Adhering to PRISMA guidelines, this meta-analysis considered randomized and nonrandomized studies meeting specific criteria, encompassing intracranial HB and preoperative embolization. Primary outcomes were preoperative embolization efficacy and safety. Complications were classified as major (cerebellar ischemia, ischemic strokes, intratumoral hemorrhage, subarachnoid hemorrhage) and minor (transient nystagmus, slight facial nerve palsy, nausea, transient dysarthria, hemiparesis, hemisensory impairment, thrombotic complications, extravasation). Thirteen studies involving 166 patients with preoperative embolization before HB resection were included. Two studies using the Glasgow Outcome Scale (GOS) showed 5 patients with good recovery, 6 with moderate disability, and 3 with severe disability. Major complications occurred in 1% (95% CI: 0% to 3%), and minor complications occurred in 1% (95% CI: 0% to 4%). Intraoperative blood loss during resection was estimated at 464.29 ml (95% CI: 350.63 ml to 614.80 ml). Preoperative embolization holds promise in reducing intraoperative bleeding risk in neurosurgical intracranial HB treatment, primarily due to its low complication rates. Nonetheless, additional research and larger-scale studies are essential to establish its long-term efficacy and safety. These findings highlight preoperative embolization as a valuable tool for HB management, potentially enhancing future patient outcomes. [ABSTRACT FROM AUTHOR]

To evaluate the clinical outcomes of transcatheter arterial embolization (TAE) with n-butyl-2-cyanoacrylate (NBCA) for treatment of bleeding in cirrhotic patients. A total of 35 cirrhotic patients (26 men, 9 women; mean age, 48.4 ± 11.1) who underwent TAE with NBCA for bleeding from January 2011 to December 2020 were retrospectively analysed. Only cirrhotic patients with active arterial bleeding confirmed on computed tomography (CT) were included. Fifteen patients were hemodynamically unstable before embolization procedure, and coagulopathy was observed in 32 patients. The mean MELD score and Child Pugh score were 24 ± 9.9 and 9.9 ± 2.2, respectively. The mean haemoglobin level and mean number of RBC units transfused before embolization were 7.4 ± 1.4 g/dL and 10.2 ± 4, respectively. The technical, clinical success rate and 30-day mortality rate were evaluated. Technical success and clinical success rates were achieved in 100% and 82.8% of patients, respectively. Overall 30-day mortality rate was 48%. No major complications related to the embolization procedure was seen. Only the greater number of RBC units transfused before the embolization procedure (OR = 1.81, 95% CI = 1.17–2.80, P = 0.007) was significantly associated with clinical failure. Greater number of RBC units transfused (OR = 1.53, 95% CI: 1.00–2.34, P = 0.004) and higher Child Pugh score (OR 2.44, 95% CI 1.26–4.71, P = 0.008) were significantly associated with higher 30-day mortality rate. Transcatheter arterial embolization using NBCA can be used as the effective treatment option for bleeding in cirrhotic patients which has a high technical and clinical success despite the grave prognosis associated with cirrhosis. [ABSTRACT FROM AUTHOR]

A subset of patients with chronic subdural hematoma (CSDH) remains refractory to standard treatment with hematoma drainage by burr-hole craniotomy and irrigation. We recently reported the usefulness of middle meningeal artery (MMA) embolization for intractable CSDH in patients with multiple intractable risk factors. We present the midterm outcomes of MMA embolization in patients with intractable CSDHs. Seventeen consecutive patients (average age, 76.4 years; 12 men [71%]) underwent MMA embolization of CSDH from January 2014 to July 2017. Earlier interventions included embolization using N -butyl-2-cyanoacrylate (although trisacryl gelatin microspheres were used in recent cases), followed by burr-hole craniotomy and irrigation in all cases. None of the patients experienced perioperative complications or postoperative recurrence. The modified Rankin Scale scores, which were unfavorable at admission, improved significantly at discharge but were comparable to those at the time of hospitalization when measured during the follow-up period. Although the patients required rehospitalization at other departments for unrelated causes, none required rehospitalization in our department. Despite the known unfavorable outcomes of patients with intractable CSDHs, MMA embolization was not associated with recurrent CSDH or rehospitalization in our department in the current case series. MMA embolization should be considered a preferred therapeutic option for intractable CSDHs. [ABSTRACT FROM AUTHOR]

Symptomatic slow-flow vascular malformations include venous malformations and lymphatic malformations, as well as combined anomalies. Endovascular therapy, consisting mainly of intralesional sclerosant injection, is now accepted as the primary treatment for most of these lesions. Magnetic resonance imaging and ultrasonography supplement physical examination for diagnosis and assessment of the extent of malformation. Endovascular treatment is usually carried out under general anesthesia. Sclerosants for venous malformations include ethanol, 3% sodium tetradecyl sulfate, and bleomycin. Lymphatic malformations can be injected with doxycycline, bleomycin, OK-432, or other sclerosants. Complications of sclerotherapy include tissue necrosis, peripheral nerve injury, hemoglobinuria, deep vein thrombosis, and pulmonary embolism. Although most vascular malformations are not cured, the majority of patients benefit from endovascular treatment. [ABSTRACT FROM AUTHOR]

Abstract: A 29-year-old woman with placenta increta with hemorrhage underwent uterine artery embolization using 12.5% NBCA (N-butyl 2-cyanoacrylate) diluted with iodized oil (Lipiodol). Complete resolution of placenta increta without performing curettage was obtained. The uterus returned to its normal shape, with restored endometrium, junctional zone, and myometrium. Menstruation resumed after 3 months. In cases of retained placenta due to placenta accreta, and even those with placenta increta, uterine artery embolization using NBCA is a useful treatment. [Copyright &y& Elsevier]

• The experimental structure was characterized by FT-IR, UV-Vis and NMR. • The optimized geometry is computed and spectroscopic properties of NBCA were examined • The nonlinear optical properties have been evaluated for the different conformations. • MEP and energy gaps of frontier orbital (HOMO–LUMO) have been calculated. • Hirshfeld surface analysis and fingerprint plots were carried out. In this research, we have compared theoretical and experimental results such as the molecular structure, vibration frequencies, UV-Vis, chemical shift values of 1H and 13C NMR of (E)-N-(4-nitrobenzylidene)-3-chlorobenzenamine (NBCA). The experimental data have been collected from a high-resolution X-ray diffraction pattern and the theoretical analyses have been carried out using the density functional theory (DFT) based on B3LYP level at 6-31++G (d, p) by Gaussian program, knowing that every single vibration frequency is awarded on the potential energy distribution (PED) base and electronic transitions are computed according to the time-dependent density functional theory (TD-DFT). The non-linear optical parameters (NLO) have similarly been investigated at the same level theory. The energies of the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) and the global chemical reactivity descriptors (GCRD) of the title molecule were investigated by using DFT/B3LYP/6-311++G (d, p) method. Molecular electrostatic potential (MEP) is simulated to look for better reactive sites for electrophilic and nucleophilic attacks. To ascertain the contribution of intermolecular interactions, Hirshfeld surface analysis and fingerprint plots were carried out. To determine the biological activity of NBCA molecule, the basic prediction of substance activity spectra (PASS) and molecular docking are studied. [ABSTRACT FROM AUTHOR]

Objective This study aimed to examine whether there is a difference in the difficulty of extirpation after use of Embosphere versus n-butyl 2-cyanoacrylate (NBCA) for the embolization of meningiomas. Methods Study subjects were 20 patients with meningioma who underwent embolization using either NBCA or Embosphere from April 2012 to December 2016. The difficulty of extirpation was compared and assessed in terms of objective indices, such as operative duration, perioperative bleeding, and Simpson grade, and in terms of subjective indices such as “impression on operative field” and “hardness of tumors” that the surgeon assessed using 3-point scales (dry, moderate, bloody, and soft, moderate, hard, respectively). Pathologic findings, including ischemia, necrosis, and inflammatory changes, were assessed. Results No significant differences were found between the 2 groups regarding the mean values of operative duration ( P = 0.27), perioperative bleeding ( P = 0.23), and Simpson grade ( P = 0.39). On the other hand, there was a significant difference with respect to the “impression on operative field” and “hardness of tumors,” with reports of dry (54%; P = 0.034) and soft (81%; P = 0.0001), respectively, in the Embosphere group exceeding those of the NBCA group. The pathologic findings showed that although ischemic change ( P = 0.43) and necrosis ( P = 0.79) were observed in both groups, perivascular inflammation was observed only in the NBCA group ( P = 0.006). Conclusions No relative merits were found regarding objective indices, whereas the Embosphere group had superior “ease of extirpation” as reported by the surgeon. [ABSTRACT FROM AUTHOR]

Objective: To report a case of full-term delivery after uterine artery embolization with N-butyl cyanoacrylate for abruptio placentae. Design: Case report. Setting: University hospital. Patient(s): A 35-year old woman, gravida 2 para 0, at 32 weeks'' and 4 days'' gestation. Intervention(s): Transcatheter arterial embolization with N-butyl cyanoacrylate (NBCA). Result(s): An emergency cesarean section was performed for abruptio placentae. The neonate died on day 0. After the cesarean section, a hematoma was found at the uterine incision that continued to increase. Therefore, pelvic angiography was performed, and extravasation was observed from the uterine arteries. NBCA was used for embolization, and the extravasation stopped rapidly. Total transfusion volume was 10,190 mL. Nine months after the cesarean section, the patient became pregnant naturally and delivered a boy by elective cesarean section. Conclusion(s): For treatment of shock caused by perinatal hemorrhage, which is a major cause of perinatal mortality, even if clotting abnormalities are present, transcatheter arterial embolization using NBCA can provide effective hemostasis. Moreover, in patients who would otherwise require a hysterectomy, fertility can be preserved. [Copyright &y& Elsevier]