Bucrylate embolization of abdominal aortic aneurysms: an adjunct to nonresective therapy

Abdominal aneurysmectomy in a patient with an abdominal aortic aneurysm who has cardiac, renal, or pulmonary disease is associated with a high surgical mortality. Fifteen such patients underwent nonresective therapy of an abdominal aortic aneurysm consisting of an axillobifemoral bypass graft which maintains blood flow to the lower extremities. At the time of the graft the iliac vessels were ligated, occluding the outflow tract from the aneurysm, and resulting in retrograde thrombosis. In three of the 15 patients, however, the aneurysm remained patent because of patency of the hypogastric arteries. The outflow tract in these three patients was occluded by a transcatheter injection of Bucrylate, a tissue adhesive, into the distal abdominal aorta and iliac vessels. Bucrylate embolization is a potentially useful adjunct to nonresective treatment of abdominal aortic aneurysms.