4- Usage and applicability of Cyanoacrilate monomer

Learning Objectives:

to show the many and diverse interventional applicabilities of Co-momomer of N-Butyl-2-cyanoacrilate (Glubran®) in the vascular and also in the visceral field. We explain the technical aspects, tips & tricks, and the cautions for a proper usage. We present our experience over 125 cases showing differents examples.

Background:

Glubran is a biocompatible acrylic glue with CE Mark. It is former indication was to treat vascular malformations mainly in neurorradiology. Cyanoacrilate is a colourless, water density, high adhesive and radiolucent liquid substance with a characteristic smell and haemostatic and bacteriostatic properties. It polymerises in contact with any biological fluid making a solid cast that causes an irreversible occlusion of blood vessels or visceral ducts. Polimerization time lasts 60 to 90 seconds at a temperature of 45ºC. After an embolization, glue is slowly removed by means of a hydrolytic breakdown process that takes months or years depending on the amount of glue and type of tissue.

Procedure details and clinical findings:

we have to combine cyanoacrilate with lipiodol to get radiopacity. We also establish the ratio of glue/lipiodol in order to achieve different polimerization times. Catheter should be flushed previously with a non ionic liquid in order to prevent intra-catheter polimerization. The catheters required way and velocity of injection and product concentration are exposed and supported through the different cases.

Conclusion:

Glubran® has a learning curve but it is a very useful, quick, chip and safe liquid when we have to do an irreversible embolization.