Low morbidity associated with use of N-butyl cyanoacrylate liquid adhesive for preoperative transarterial embolization of central nervous system tumors

OBJECTIVE: To determine the safety and efficacy of preoperative embolization of central nervous system tumors with n-butyl cyanoacrylate (NBCA) liquid adhesive. METHODS: Over a 6-year period, 35 consecutive patients (12 women, 23 men; mean age, 42 yr; range, 6 mo-75 yr) with a central nervous system tumor underwent preoperative embolization with NBCA. Tumor type, location, endovascular and surgical treatment, percent of tumor embolization, estimated blood loss, and neurological deficits related to embolization were evaluated retrospectively. RESULTS: One hundred feeding arteries were embolized (mean, 3 vessels/patient). In only one (3%) case was a normal artery inadvertently occluded by the embolization. During the follow-up period, the resulting neurological deficit resolved completely. There were no neurological deficits or inadvertent embolization events in the remaining 34 cases. The mean percent of tumor embolized was 68%, but this did not significantly correlate with operative blood loss (Pearson's correlation coefficient, r = 0.049). CONCLUSION: In experienced hands, central nervous system tumors can be embolized with NBCA liquid adhesive with a high degree of safety and efficacy. We think that adroit embolization technique with NBCA and other embolisates should be part of the contemporary neuroendovascular armamentarium.