Cyanoacrylates are a group of fast-acting adhesives. They form low viscosity liquids in the monomer state and instantly polymerize to become adhesive upon contact with ionic substances. Since the 1950s, they have been used around the world for industrial and household purposes.
N-butyl cyanoacrylate (NBCA) is a
cyanoacrylate that is commonly used for medical care, and the closure of skin
wounds with NBCA has been found to promote hemostasis. However, in Japan, the intravascular injection of NBCA is considered to be
off-label use, except during the treatment of
gastric varices under endoscopy. The use of NBCA in
embolotherapy is considered when the target vessels cannot be cannulated superselectively, for
vascular diseases that require long segments of the target vessel to be embolized, or for patients in a hypocoagulable state. NBCA-based
embolotherapy can be used to treat
vascular malformations, acute hemorrhaging,
tumors, and venous disease. The complications associated with NBCA-based
embolotherapy include tissue
ischemia, hemorrhaging, systemic or local reactions, and
catheter adhesion to blood vessels. NBCA is mixed with
Lipiodol to make it radiopaque and to adjust its polymerization time. Since there are various technical aspects to performing NBCA-based
embolotherapy safely, it should be carried out by, or with the assistance of, proficient interventional radiologists.