In vitro characterization of cyanoacrylate embolic glues used for vascular embolization

Vascular embolization is a minimally invasive treatment used to selectively eliminate or stop the vascular supply to specific body areas. One technique consists of navigating a microcatheter into the targeted blood vessel and injecting an embolic agent which reacts in contact with blood. Cyanoacrylate-based embolic glues are the main liquid adhesives used for vascular embolization owing to their low viscosity, good penetration ability and low tissue toxicity. To enable its detection once injected, the glue is mixed with a radio-opaque contrast agent such as the Lipiodol iodized oil. Although the technique is commonly used, there is very little information on the dynamics of the injection process in complex blood flows or on the polymerization kinetics of the glue-Lipiodol mixture. Consequently, safe occlusion is difficult to achieve, even in the hands of experienced radiologists. The main objective of the thesis is to quantitatively investigate the physical properties and polymerization kinetics of cyanoacrylate glues mixed with Lipiodol in different proportions. We have designed a new experimental setup to characterize the polymerization process of a glue/Lipiodol mixture on contact with an ionic or proteinaceous solution. We find that there is a fast polymerization process at the interface between the glue and the substrate, followed by the propagation of a polymerization front in the glue mixture volume. The time constants of the processes depend on the solution and glue mixture compositions. Another objective is to analyze the dynamic embolization process. An in vitro model of the injection process is used to first investigate the drop formation between two non-reacting immiscible flows. The injection of a glue mixture into a flowing ionic solution is then performed to show the joint influence of polymerization and hydrodynamics. It is the first time that such comprehensive characterization of cyanoacrylate-based embolic glues is acquired. The results can provide crucial information to interventional radiologists, that will help them understand and control the glue behavior after injection to achieve a safe and permanent obliteration of the vessels.