Lipiodol® Ultra-Fluid (Iodinated ethyl esters of fatty acids of poppy seed oil)Indication in Vascular Embolization

Lipiodol® Ultra-Fluid (Iodinated ethyl esters of fatty acids of poppy seed oil)
Indication in Vascular Embolization

Mastering polymerization time 1,2,3,4 for a better management of Vascular Anomalies Embolization 5,6 

PACK LIPIODOL

Indication

Lipiodol® indication in vascular embolization

Selective embolization in combination with cyanoacrylate-based glue (particularly for arteriovenous malformation or aneurysms)

Vascular anomaly embolization

Embolic vascular occlusion may be performed at any level from large arteries or veins to capillary beds, it may be temporary or permanent for treating a wide variety of conditions

Used to treat a wide variety of conditions:
• To slow down or block blood flow
• To induce liver lobe hypertrophy

For complete information please refer to country's local SPC

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Vascular anomalies(7)

  • « Vascular tumours and vascular malformations are common vasculose anomalies characteristic for dissimilar clinical course, specific biological as well as immune cytological and histological properties.»
  • « In 80% of cases, hemangiomas are single lesions observed dominantly on body integuments with their most common location on the head (60%), trunk (25%) and limbs (15%).»

Lipiodol® Ultra Fluid in vascular anomalies embolization

Features

Benefits

Visualizer

- Immediate anomaly visualization & localization for real time procedure guiding (8,9) 
- Per-procedure complete anomaly filling visual confirmation (8,10,11) 

Vectorizer & Timer

- Radiopacity & increased polymerization time thanks to Lipiodol® & NBCA mixture (1,2,4,12) 
- Modification of polymerization time according to the Lipiodol® & glue ratio (2,10,11,13,14)

Want to know more about the Procedure Protocols for Vascular Embolization?

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Want to know more about Vascular Embolization Guidelines?

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Embolization's Clinical Applications 

1. Portal vein embolization using a NBCA/ Lipiodol® mixture before right liver resection(15)

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4

LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«Placement of a pigtail catheter in the main portal branch after CT-guided puncture of the left portal vein.»

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«Catheterization of a right-sided portal branch via a microcatheter system.»

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«Visualization of the entire embolized area of the right-sided portal branches.»

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«Visualization of the entire embolized area of the right-sided portal branches.»

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«Total occlusion of the right-sided portal venous system 30 days after embolization with Histoacryl/Lipiodol®

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

«The same patient 9 months after right-sided hemihepatectomy shows a massive hypertrophy of the residual liver.»

Portal vein were embolized with a mixture of Histoacryl/Lipiodol® mean dilution ratio 1:4 LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

2. Cyanoacrylate therapy for the treatment of gastric varices: a new method(8)

Patients with bleeding large gastric varices – Cyanoacrylate/Lipiodol® Dilution ratio 1:1

LIPIODOL® & NBCA – FOR TREATMENT OF GASTRIC VARICES

 

«Endoscopic view of fundal varix (gastroesophageal varices type 1) with active bleeding before treated with cyanoacrylate.»

«Endoscopic view of gastroesophageal varices 1 after cyanoacrylate therapy, showing stoppage of bleeding.»

«Abdominal X-ray examination showing a large amount of Lipiodol®-mixed cyanoacrylate remaining at the site of large fundal varix.»

«Computed tomography scan of thorax after Lipiodol®-diluted cyanoacrylate, showing normal pulmonary vessels.»

 

Access more clinical applications

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References

Mastering polymerization time for a better management of Abnormal Vascular Embolization

1.Takeuchi Y. et al., Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition, Jpn J Radiol, 2014; 32:500–517.

2.LEE BB. et al., Consensus Document of the International Union of Angiology (IUA)-2013 Current concepts on the management of arterio-venous malformations, International Angiology, 2013;32(1):11-36.

3.Seewald S et al., A standardized injection technique and regimen ensures success and safety of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices, Gastrointestinal endoscopy, 2008,68(3): 447-454

4.American Society for Gastrointestinal Endoscopy. Tissue adhesives: cyanoacrylate glue and fibrin sealant, Gastrointestinal Endoscopy, 2013;78: 2. 209-215.

5.Madhusudhan KS. et al., Endovascular Embolization of Visceral Artery Pseudoaneurysms Using Modified Injection Technique with N-Butyl Cyanoacrylate Glue, J VascInterv Radiol, 2015;26:1718–1725.

6.Lo GH. et al., A Prospective, Randomized Trial of Butyl Cyanoacrylate Injection Versus Band Ligation in the Management of Bleeding Gastric Varices, Hepatology,2001; 33( 5), 1060-1064.

7.Wójcicki P. et al., Epidemiology, Diagnostics and Treatment of Vascular Tumours and Malformations, Adv Clin Exp Med, 2014; 23, 3, 475–484.

8.Singh V. et al., Cyanoacrylate therapy for the treatment of gastric varices: a new method, Journal of Digestive Diseases, 2016;17: 392–398.

9.Urbano J. et al., Sclerosis and varicocele embolization with N-butyl cyanoacrylate: experience in 41 patients, Acta Radiol., 2014; 55(2):179-185.

10.Kwak H.S. et al, Percutaneous Transportal Sclerotherapy with N-Butyl-2-Cyanoacrylate for Gastric Varices: Technique and Clinical Efficacy, Korean J. Radiol. 2008; 9:526-533.

11.Kanematsu M. et al., Postpartum Hemorrhage in Coagulopathic Patients: Preliminary Experience with Uterine Arterial Embolization with N-Butyl Cyanoacrylate, J. Vasc. Interv. Radiol, 2011; 22:1773-1776.

12.Simons M.E. et al., Peripheral vascular malformations: diagnosis and percutaneous management, Can. Assoc. Radiol. J., 2001; 52(4):242-251.

13.Loffroy R. et al., Endovascular Therapeutic Embolisation: An Overview of Occluding Agents and their Effects on Embolised Tissues, Curr. Vasc. Pharmacol., 2009; 7:250-263.

14.Gandini R. et al., Transcatheter Embolization of a Large Symptomatic Pelvic Arteriovenous Malformation with Glubran 2 Acrylic Glue, Cardiovasc. Intervent. Radiol. 2008; 31:1030-1033.

15.Bellemann N. et al., Portal vein embolization using a Histoacryl / Lipiodol mixture before right liver resection, Dig. Surg., 2012; 29:236-242.

Drakon CTA

DraKon™ Microcatheter

Lymphograhy CTA

Lymphography

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