Abstract
Purpose: To investigate the optimal order of mixing N-butyl-2-cyanoacrylate-Lipiodol-iodine contrast materials (N-butyl cyanoacrylate-Lipiodol-iodinated contrast material). Materials and Methods: Lipiodol was used as an oil-based contrast material. Three types of water-soluble iodinated contrast materials were used: iopamidol, iohexol, and iomeprol. The materials were mixed in three different orders: N-butyl cyanoacrylate-Lipiodol-iodinated contrast material, in which N-butyl-2-cyanoacrylate was first mixed with Lipiodol and then with iodinated contrast materials; N-butyl cyanoacrylate mixed first with an iodinated contrast material and then with Lipiodol, in which N-butyl-2-cyanoacrylate was first mixed with iodinated contrast material and then with Lipiodol; and Lipiodol mixed first with an iodinated contrast material and then with N-butyl cyanoacrylate, in which Lipiodol was first mixed with iodinated contrast materials and then with N-butyl-2-cyanoacrylate. N-butyl cyanoacrylate-Lipiodol-iodinated contrast material was prepared at two ratios: 2:3:1 (N-butyl cyanoacrylate-Lipiodol-iodinated contrast material 231) and 1:4:1 (N-butyl cyanoacrylate-Lipiodol-iodinated contrast material 141). The particle sizes and injection pressures of the mixtures were measured, and their adhesiveness was evaluated. Results: N-butyl cyanoacrylate mixed first with Lipiodol and then with an iodinated contrast material and Lipiodol mixed first with an iodinated contrast material and then with NBCA could be prepared, but N-butyl cyanoacrylate mixed first with Lipiodol and then with an iodinated contrast material could not because of immediate polymerization between N-butyl-2-cyanoacrylate and iodinated contrast material. N-butyl cyanoacrylate mixed first with Lipiodol and then with an iodinated contrast material mixtures had large, irregular particles (33.1-126.5 μm) with non-uniform distribution. Lipiodol mixed first with an iodinated contrast material and then with N-butyl cyanoacrylate mixtures yielded significantly smaller, uniformly distributed particles (1.6-3.3 μm) irrespective of contrast material type. Both Lipiodol mixed first with an iodinated contrast material and then with NBCA and NBCA mixed first with Lipiodol and then with an iodinated contrast material mixtures showed no catheter adhesiveness. Conclusions: Lipiodol mixed first with an iodinated contrast material and then with NBCA is an appropriate mixing order because of its uniform particle sizes irrespective of contrast materials, and low adhesiveness compared with other mixtures.