Endovascular treatment of postcatheterization femoral arteriovenous fistulas with n-butyl-cyanoacrilate embolization
CLINICAL RADIOLOGY, cilt.95, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 95
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.crad.2026.107268
- Dergi Adı: CLINICAL RADIOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Aerospace Database, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Technology Collection (ProQuest)
- Gazi Üniversitesi Adresli: Evet
Özet
AIM: To evaluate the feasibility, safety, and outcomes of n-butyl-cyanoacrylate (nBCA) embolization in patients with iatrogenic femoral arteriovenous fistulas (AVFs). Materials and Methods: This retrospective study included 22 patients (13 men, 9 women; mean age 63.6 +/- 8.0 years) who underwent nBCA embolization for femoral AVFs. Diagnosis was confirmed by Doppler ultrasound. Procedures involved selective catheterization and injection of an nBCA and ethiodized oil mixture under angiographic guidance. Follow-up was performed with Doppler ultrasound at 1 and 12 months. Technical success was defined as angiographic elimination of early venous filling without the need for additional treatment. Group comparisons used the Mann-Whitney U test, and the impact of tract length on outcomes was evaluated by ROC analysis. Effect size (Cohen's h) and post-hoc power analysis were performed. Results: Technical success was achieved in 19 of 22 patients (86.3 %). The median fistula tract length was 13.5 mm (range: 6-36 mm). Success rates were significantly higher for tracts >6.5 mm (94.7 % vs. 33 %; p=0.035, Cohen's h approximate to 1.51). ROC analysis showed an AUC of 0.886 (95 % CI: 0.710-1.000), with 94.7 % sensitivity and 66.7 % specificity at a 6.5 mm cut-off. Post-hoc power was 76 %. Two patients required stent-graft placement for incomplete closure. One case of asymptomatic partial venous glue migration occurred, with no clinical sequelae. No major complications or recurrences were observed. Conclusion: nBCA embolization is a safe and effective treatment for iatrogenic femoral AVFs, especially with sufficient tract length. It is a promising alternative to surgery or stent-graft placement. (c) 2026 The Royal College of Radiologists. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.