13th Annual Global Embolization Symposium & Technologies
Purpose : To evaluate polymerization of different acrylate glue/iodized oil mixtures for lymphatic interventions in-vitro.
Material and Methods : Polymerization of Histoacryl (HA) [Bayer Healthcare] and Glubran 2 (GL) [GEM] mixed with iodized oil (ratios 1:0 - 1:7) were investigated for two lymphatic fluid samples (low triglycerides (TG) <50mg/dl and high TG >600mg/dl).
For analysis of static polymerization time, the glue mixtures were dropped on the sample and morphological changes were monitored by video.
To simulate thoracic duct embolization dynamic experiments were performed in a silicon tube with different lymph flow rates (1500ml/24h and 6000ml/24h). A microcatheter was used for glue injection into the flowing lymph after a glucose flush with different volumes (only catheter filled and 5ml glucose). Time to total occlusion of the tube was measured.
Results : For both glues static polymerization times were longer when iodized oil content was increased and when performed in TG-rich lymphatic fluid. GL generally showed shorter polymerization times than HA (for low TG: glue/oil ratio 1:3: 241s (HA) vs. 123s (GL), ratio 1:7: 4096s (HA) vs. 2363s (GL); for high TG: ratio 1:3: 374s (HA) vs. 143s (GL), ratio 1:7: 9770s (HA) vs. 5580s (GL)). Prolongation of polymerziation due to higher TG levels was more pronounced for HA.
In dynamic experiments prolongation of polymerization due to oil content and TG levels was less pronounced for both glue types. For low TG total occlusion of the silicon tube was observed in all cases for HA between 32s (1:1) and 56s (1:7) and for GL between 17s (1:1) and 50s (1:7) with again slightly faster polymerization of GL. For high TG levels polymerization took considerably longer (between 43s and 410s for HA; and between 29s and 319s for GL) or failed completely. There were no systematic differences for varying lymphatic flow rates and different glucose flush volumes.
Conclusions : Polymerization time of glue/iodized oil mixtures in lymph is prolonged both by increasing iodized oil and triglyceride concentrations. Polymerization time for Glubran seems to be slightly shorter than for Histoacryl. Lymphatic flow rate and glucose flush volume do not significantly influence polymerization times.