Predicting brain tumor regrowth in relation to motor areas by functional brain mapping

Abstract Background Due to frequent recurrences, high-grade gliomas still confer a poor prognosis. Several regrowth prediction models have been developed, but most of these models are based on cellular models or dynamic mathematical calculations, thus limiting direct clinical use. The present study aims to evaluate whether navigated transcranial magnetic stimulation (nTMS) or functional magnetic resonance imaging (fMRI) may be used to predict the direction of tumor regrowth. Methods Sixty consecutive patients with high-grade gliomas were enrolled prospectively and analyzed in a case-control design after tumor recurrence. All patients underwent serial MRI after surgery and suffered from recurrent tumors during a mean follow-up of 13.2 ± 14.9 months. Tumor regrowth speed and direction were measured in relation to motor areas defined by nTMS, nTMS-based tractography, and fMRI. Depending on initial resection, patients were separated into three groups (group 1: without residual tumor, group 2: residual tumor away from motor areas, and group 3: residual tumor facing motor areas). Results Sixty-nine percent of patients in group 1, 64.3% in group 2, and 66.7% in group 3 showed tumor recurrence towards motor eloquence on contrast-enhanced T1-weighted sequences (P = .9527). Average growth towards motor areas on contrast-enhanced T1-weighted sequences was 0.6 ± 1.5 (group 1), 0.6 ± 2.4 (group 2), and 2.3 ± 5.5 (group 3) mm/month (P = .0492). Conclusion This study suggests a new strategy to predict tumor regrowth patterns in high-grade glioma patients. Our approach could be directly applied in the clinical setting, thus having clinical impact on both surgical treatment and radiotherapy planning. Ethics Committee Registration Number 2793/10.

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Regional Cerebral Plasma Volume Response to Carbon Dioxide Using Magnetic Resonance Imaging

Anesthesiology ◽

10.1097/00000542-199804000-00019 ◽

1998 ◽

Vol 88 (4) ◽

pp. 984-992 ◽

Cited By ~ 27

Author(s):

Jean-Francois Payen ◽

Albert Vath ◽

Blanche Koenigsberg ◽

Virginie Bourlier ◽

Michel Decorps

Keyword(s):

Magnetic Resonance Imaging ◽

Carbon Dioxide ◽

Magnetic Resonance ◽

Plasma Volume ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Group 3 ◽

Group 2 ◽

Agent Group ◽

Group 1

Background Noninvasive techniques used to determine the changes in cerebral blood volume in response to carbon dioxide are hampered by their limited spatial or temporal resolution or both. Using steady state contrast-enhanced magnetic resonance imaging, the authors determined regional changes in cerebral plasma volume (CPV) induced by hypercapnia in halothane-anesthetized rats. Methods Cerebral plasma volume was determined during normocapnia, hypercapnia and recovery in the dorsoparietal neocortex and striatum of each hemisphere, in cerebellum, and in extracerebral tissue of rats with either intact carotid arteries (group 1) or unilateral common carotid ligation (group 2). Another group was studied without injection of a contrast agent (group 3). Results Hypercapnia (partial pressure of carbon dioxide in arterial blood [PaCO2] approximately 65 mmHg) resulted in a significant increase in CPV in the striatum (+42 +/- 8%), neocortex (+34 +/- 6%), and cerebellum (+49 +/- 12%) compared with normocapnic CPV values (group 1). Carotid ligation (group 2) led to a marked reduction of the CPV response to hypercapnia in the ipsilateral striatum (+23 +/- 14%) and neocortex (+27 +/- 17%) compared with the unclamped side (+34 +/- 15% and +38 +/- 16%, respectively). No significant changes in CPV were found in extracerebral tissue. In both groups, the CPV changes were reversed by the carbon dioxide washout period. Negligible changes in contrast imaging were detected during hypercapnia without administration of the contrast agent (group 3). Conclusions The contrast-enhanced magnetic resonance imaging technique is sensitive to detect noninvasively regional CPV changes induced by hypercapnia in rat brain. This could be of clinical interest for determining the cerebrovascular reactivity among different brain regions.

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Frequency and characterization of gastro–entero–pancreatic neuroendocrine tumor patients with high-grade of uptake at somatostatin receptor scintigraphy

Endocrine Related Cancer ◽

10.1530/erc-12-0169 ◽

2013 ◽

Vol 20 (2) ◽

pp. 229-239 ◽

Cited By ~ 5

Author(s):

Cecile N Chougnet ◽

Sophie Leboulleux ◽

Caroline Caramella ◽

Jean Lumbroso ◽

Isabelle Borget ◽

...

Keyword(s):

Somatostatin Receptor ◽

Peptide Receptor Radionuclide Therapy ◽

Pancreatic Neuroendocrine Tumor ◽

Somatostatin Receptor Scintigraphy ◽

Neuroendocrine Neoplasm ◽

High Grade ◽

Receptor Scintigraphy ◽

Group 3 ◽

Group 2 ◽

Group 1

Recent studies suggest that the somatostatin receptor scintigraphy (SRS) grade of uptake is a predictor of response to peptide receptor radionuclide therapy (PRRT). To identify and characterize patients with well-differentiated (WD) neuroendocrine neoplasm (NEN) displaying a high-grade uptake at SRS. Patients with WD-NEN, whose SRS films were available for review, were retrospectively included. SRS was reviewed by three independent readers and classified into four subgroups based on a modified Krenning's scale (mKS): no uptake (group-0), homogeneous grade 1–2 uptake (group-1), homogeneous grade 3–4 (group-2), and heterogeneous grade 1–4 (group-3). A simplified scale (sS) of SRS was also used to look for characteristics of patients with high-grade uptake. One hundred and six WD-NEN patients were enrolled. Group-0, group-1, group-2, and group-3 were found in 17, 8, 33, and 42% of cases respectively. High-grade uptake at sS (75% of cases) was correlated with older age, functioning NEN, high chromogranin-A level, and grade 1 (G1) NEN based on mitotic count. Based on the mKS or sS scales, no difference on survival was found. Thirty-three to seventy-five percent of metastatic NEN patients can be considered candidates for PRRT based on homogeneous or heterogeneous high-grade uptake. Functioning G1 NEN patients could be the best candidates for PRRT. Randomized trials are expected to confirm this result.

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Alterations in ALK/ROS1/NTRK/MET drive a group of infantile hemispheric gliomas

Nature Communications ◽

10.1038/s41467-019-12187-5 ◽

2019 ◽

Vol 10 (1) ◽

Cited By ~ 32

Author(s):

Ana S. Guerreiro Stucklin ◽

Scott Ryall ◽

Kohei Fukuoka ◽

Michal Zapotocky ◽

Alvaro Lassaletta ◽

...

Keyword(s):

Tyrosine Kinases ◽

Receptor Tyrosine Kinases ◽

Therapeutic Strategies ◽

Low Grade ◽

High Grade ◽

Term Survival ◽

Group 3 ◽

Group 2 ◽

Group 1

Abstract Infant gliomas have paradoxical clinical behavior compared to those in children and adults: low-grade tumors have a higher mortality rate, while high-grade tumors have a better outcome. However, we have little understanding of their biology and therefore cannot explain this behavior nor what constitutes optimal clinical management. Here we report a comprehensive genetic analysis of an international cohort of clinically annotated infant gliomas, revealing 3 clinical subgroups. Group 1 tumors arise in the cerebral hemispheres and harbor alterations in the receptor tyrosine kinases ALK, ROS1, NTRK and MET. These are typically single-events and confer an intermediate outcome. Groups 2 and 3 gliomas harbor RAS/MAPK pathway mutations and arise in the hemispheres and midline, respectively. Group 2 tumors have excellent long-term survival, while group 3 tumors progress rapidly and do not respond well to chemoradiation. We conclude that infant gliomas comprise 3 subgroups, justifying the need for specialized therapeutic strategies.

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Differentiation of Benign Angiomatous and Microcystic Meningiomas with Extensive Peritumoral Edema from High Grade Meningiomas with Aid of Diffusion Weighted MRI

BioMed Research International ◽

10.1155/2014/650939 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 11

Author(s):

Avetis Azizyan ◽

Paula Eboli ◽

Doniel Drazin ◽

James Mirocha ◽

Marcel M. Maya ◽

...

Keyword(s):

World Health ◽

Low Grade ◽

High Grade ◽

Peritumoral Edema ◽

Who Grade ◽

Significant Group ◽

Adc Value ◽

Group 3 ◽

Group 2 ◽

Group 1

Objective. To determine whether angiomatous and microcystic meningiomas which mimic high grade meningiomas based on extent of peritumoral edema can be reliably differentiated as low grade tumors using normalized apparent diffusion coefficient (ADC) values.Methods. Preoperative magnetic resonance imaging (MRI) of seventy patients with meningiomas was reviewed. Morphologically, the tumors were divided into 3 groups. Group 1 contained 12 pure microcystic, 3 pure angiomatoid and 7 mixed angiomatoid and microcystic tumors. Group 2 included World Health Organization (WHO) grade II and WHO grade III tumors, of which 28 were atypical and 9 were anaplastic meningiomas. Group 3 included WHO grade I tumors of morphology different than angiomatoid and microcystic. Peritumoral edema, normalized ADC, and cerebral blood volume (CBV) were obtained for all meningiomas.Results. Edema index of tumors in group 1 and group 2 was significantly higher than in group 3. Normalized ADC value in group 1 was higher than in group 2, but not statistically significant between groups 1 and 3. CBV values showed no significant group differences.Conclusion. A combination of peritumoral edema index and normalized ADC value is a novel approach to preoperative differentiation between true aggressive meningiomas and mimickers such as angiomatous and microcystic meningiomas.

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Qualitative Heterogeneous Signal Drop on Chemical Shift (CS) MR Imaging: Correlative Quantitative Analysis between CS Signal Intensity Index and Contrast Washout Parameters Using T1-Weighted Sequences

Tomography ◽

10.3390/tomography7040079 ◽

2021 ◽

Vol 7 (4) ◽

pp. 961-971

Author(s):

Arnaldo Stanzione ◽

Francesco Verde ◽

Roberta Galatola ◽

Valeria Romeo ◽

Raffaele Liuzzi ◽

...

Keyword(s):

Chemical Shift ◽

Signal Intensity ◽

Characteristic Analysis ◽

Intensity Index ◽

Quantitative Parameters ◽

Group 3 ◽

Group 2 ◽

Post Hoc ◽

Weighted Sequences ◽

Group 1

The aim of this study was to calculate MRI quantitative parameters extracted from chemical-shift (CS) and dynamic contrast-enhanced (DCE) T1-weighted (T1-WS) images of adrenal lesions (AL) with qualitative heterogeneous signal drop on CS T1-WS and compare them to those of AL with homogeneous or no signal drop on CS T1-WS. On 3 T MRI, 65 patients with a total of 72 AL were studied. CS images were qualitatively assessed for grouping AL as showing homogeneous (Group 1, n = 19), heterogeneous (Group 2, n = 23), and no (Group 3, n = 30) signal drop. Histopathology or follow-up data served as reference standard to classify AL. ROIs were drawn both on CS and DCE images to obtain adrenal CS signal intensity index (ASII), absolute (AWO), and relative washout (RWO) values. Quantitative parameters (QP) were compared with ANOVA analysis and post hoc Dunn’s test. The performance of QP to classify AL was assessed with receiver operating characteristic analysis. CS ASII values were significantly different among the three groups (p < 0.001) with median values of 71%, 53%, and 3%, respectively. AWO/RWO values were similar in Groups 1 (adenomas) and 2 (benign AL) but significantly (p < 0.001) lower in Group 3 (20 benign AL and 10 malignant AL). With cut-offs, respectively, of 60% (Group 1 vs. 2), 20% (Group 2 vs. 3), and 37% (Group 1 vs. 3), CS ASII showed areas under the curve of 0.85, 0.96, and 0.93 for the classification of AL, overall higher than AWO/RWO. In conclusion, AL with qualitative heterogeneous signal drop at CS represent benign AL with QP by DCE sequence similar to those of AL with homogeneous signal drop at CS, but different to those of AL with no signal drop at CS; ASII seems to be the only quantitative parameter able to differentiate AL among the three different groups.

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Intraoperative magnetic resonance imaging in pediatric neurosurgery: safety and utility

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.8.peds15708 ◽

2017 ◽

Vol 19 (1) ◽

pp. 77-84 ◽

Cited By ~ 17

Author(s):

Mario Giordano ◽

Amir Samii ◽

Anna C. Lawson McLean ◽

Helmut Bertalanffy ◽

Rudolf Fahlbusch ◽

...

Keyword(s):

High Field ◽

Tumor Resection ◽

Pediatric Neurosurgery ◽

Residual Tumor ◽

Subtotal Resection ◽

Low Grade ◽

Neurosurgical Procedures ◽

Group 3 ◽

Group 2 ◽

Group 1

OBJECTIVE The use of high-field intraoperative MRI has been largely studied for the treatment of intracranial tumors in adult patients. In this study, the authors investigated the safety, advantages, and limitations of high-field iMRI for cranial neurosurgical procedures in pediatric patients, with particular attention to craniopharyngiomas and gliomas. METHODS The authors performed 82 surgical procedures in patients under 16 years of age (range 0.8–15 years) over an 8-year period (2007–2014) using iMRI. The population was divided into 3 groups based on the condition treated: sellar region tumors (Group 1), gliomas (Group 2), and other pathological entities (Group 3). The patients' pre- and postoperative neurological status, the presence of residual tumor, the number of intraoperative scans, and complications were evaluated. RESULTS In Group 1, gross-total resection (GTR) was performed in 22 (88%) of the procedures and subtotal resection (STR) in 3 (12%). In Group 2, GTR, STR, and partial resection (PR) were performed, respectively, in 15 (56%), 7 (26%), and 5 (18%) of the procedures. In Group 3, GTR was performed in 28 (93%) and STR in 2 (7%) of the procedures. In cases of craniopharyngioma (Group 1) and glioma (Group 2) in which a complete removal was planned, iMRI allowed localization of residual lesions and attainment of the surgical goal through further resection, respectively, in 18% and 27% of the procedures. Moreover, in gliomas the resection could be extended from partial to subtotal in 50% of the cases. In 17% of the patients in Group 3, iMRI enabled the identification and further removal of tumor remnants. There was no intra- or postoperative complication related to the use of iMRI despite special technical difficulties in smaller children. CONCLUSIONS In this study, the use of iMRI in children proved to be safe. It was most effective in increasing the extent of tumor resection, especially in patients with low-grade gliomas and craniopharyngiomas. The most prominent disadvantage of high-field iMRI was the limitation with respect to operative positioning due to the configuration of the surgical table.

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Contrast-Enhanced Ultrasound in Residual Tumor of Hepatocellular Carcinoma following Transarterial Chemoembolization: Is It Helpful for Tumor Response?

BioMed Research International ◽

10.1155/2018/8632069 ◽

2018 ◽

Vol 2018 ◽

pp. 1-11 ◽

Cited By ~ 2

Author(s):

Tian’an Jiang ◽

Qiyu Zhao ◽

Min Huang ◽

Junhui Sun ◽

Guo Tian

Keyword(s):

Hepatocellular Carcinoma ◽

Rise Time ◽

Transarterial Chemoembolization ◽

Residual Tumor ◽

Arterial Phase ◽

Peak Time ◽

Enhancement Pattern ◽

Contrast Enhanced ◽

Group 2 ◽

Group 1

Aim. To investigate the enhancement pattern of residual tumor on contrast-enhanced ultrasonography (CEUS) in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).Methods. Our study initially included 76 patients with HCC, 73 of which were finally allocated into two groups: group 1 (43 patients, post-TACE group) and group 2 (30 patients, untreated HCC group). All patients were performed with CEUS using SonoVue, and qualitative and quantitative enhancement characteristics (rise time, peak time, and washout time) were evaluated for the residual tumors. T test orχ2test was used to estimate for differences between two groups.Results. In group 1, the mean rise time, peak time, and washout times in group 1 were 16.1±2.7 sec, 31.3±3.1 sec, and 191.0±31.3 sec, respectively. In group 2, these were 15.1±3.5 sec, 30.9±3.2 sec, and 142.6±16.1 sec, respectively. The differences in rise time and peak time were not statistically significant (P=0.09 and 0.30, respectively), but the washout time was significantly prolonged in group 1 (P<0.01). The enhanced pattern in arterial phase was inhomogeneous (n=11), regular homogeneous (n=11), partial (n=12), peripheral (n=7), and peripheral rim-like (n=2) in group 1. The average of the longest tumor size of the whole lesion in the 5 types was 4.7±1.3cm, 2.9±1.0cm, 3.1±1.7cm, 2.5±0.6cm, and 2.1 cm.Conclusion. It suggested that the washout time of post-TACE residual lesions was prolonged compared with untreated HCC nodules on CEUS imaging. Combined with the triple-phase enhancement pattern seen on CEUS, the washout time may provide additional information to guide further treatment for residual tumors.

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Contrast enhanced magnetic resonance imaging in assessment of aortic atherosclerosis and its relation to severity of myocardial injury due to infarction

Russian Journal of Cardiology ◽

10.15829/1560-4071-2019-12-10-14 ◽

2019 ◽

pp. 10-14

Author(s):

A. S. Maksimova ◽

V. E. Sinitsyn ◽

Yu. B. Lishmanov ◽

W. Yu. Ussov

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Myocardial Injury ◽

Aortic Wall ◽

Aortic Atherosclerosis ◽

Resonance Imaging ◽

Contrast Enhanced ◽

Group 3 ◽

Group 2 ◽

Group 1

Aim. To study the contrast enhanced magnetic resonance imaging (CE-MRI) role in assessment of aortic atherosclerosis and its relation to severity of myocardial injury in myocardial infarction (MI) patients which underwent cardiac MRI before coronary artery bypass grafting and Dor or Menicanti procedures.Material and methods. The study included 42 patients (38 men, 4 women) who underwent CE-MRI (mean age 57,7±8,75 years). In order to analyze the aortic atherosclerosis, axial T1 weighted images before and after 10-15 minutes after CE was evaluated. Along with visual analysis, the diameter, thickness of the aortic wall, and index of enhancement (IE) of T1 weighted image (WI) (TR=400-650 ms, TE=12-20 ms), as the ratio of postand precontrast intensities of the aortic wall: IE=(Intensity T1-WI post-contrast)/ (Intensity T1-WI pre-contrast) were determined. According to the cardiac CEMRI, the proportion of left ventricle (LV) injury as the ratio of the MI injury and theLV mass was estimated.Results. Depending on aortic IE value, patients were divided into three groups: group 1 (9 people) with IE ≤1,05; group 2 (15 people) with 1,05< IE ≤1,15; group 3 (18 people) with IE >1,15. We compared the descending aortic wall thickness and the diameter among these groups. To identify intergroup differences one-way ANOVA with Bonferroni correction was carried out. There were no significant differences in the descending aortic diameters (F=0,15; p=0,86): group 1 — 2,41±0,33, group 2 — 2,54±0,63, group 3 — 2,53±0,51 cm. The thickness of the aortic wall in groups was 2,05±0,58 mm, 3,34±0,68 mm and 3,80±0,46 mm (F=17,39; p< 0,001), respectively. The first and second, first and third groups were distinguished, and there was no significant difference between the second and third groups. Between groups 1, 2 and 3 were also noted the increase and differences in proportion of LV injury, which amounted to 0,11±0,03 with a minimum IE (group 1), with an intermediate IE (group 2) — 0,19±0,08, and with high IE — 0,25±0,15.Conclusion. CE-MRI of the aortic wall can be used as a method of visualizing atherosclerosis and predicting the complications of aortic atherosclerosis. Moreover, the assessment of aortic atherosclerosis can be used in combination with conventional heart examination. The increased CE into the aortic wall in patients with advanced atherosclerosis is usually associated with a greater severity of myocardial injury. During cardiac CE-MRI it is advisable to assess the descending aorta state by calculation of IE T1-WI MRI to clarify the atherosclerosis severity and cardiovascular risk.

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Thyroid Cancer Recurrence in Patients Clinically Free of Disease with Undetectable or Very Low Serum Thyroglobulin Values

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2010-1500 ◽

2010 ◽

Vol 95 (12) ◽

pp. 5241-5248 ◽

Cited By ~ 46

Author(s):

Richard T. Kloos

Keyword(s):

Thyroid Cancer ◽

Tumor Recurrence ◽

Cancer Recurrence ◽

Whole Body ◽

Predictive Values ◽

Retrospective Clinical Study ◽

Group 3 ◽

Group 2 ◽

Thyroid Cancer Recurrence ◽

Group 1

Design: This was a retrospective clinical study. Setting: The study was conducted at a university-based tertiary cancer hospital. Patients: One hundred seven patients had initial thyroid cancer surgery and subsequent remnant radioiodine ablation. Patients underwent recombinant human TSH (rhTSH)-mediated diagnostic whole-body scan and rhTSH-stimulated thyroglobulin (Tg) measurement before April 2001 if they had no antithyroglobulin antibodies, were clinically free of disease, and had one or more undetectable (≤0.5 ng/ml) or low (0.6–1 ng/ml) basal Tg measurements on levothyroxine. Patients were stratified according to their rhTSH-Tg responses: group 1, Tg 0.5 ng/ml or less (68 patients); group 2, Tg from 0.6 to 2.0 ng/ml (19 patients); and group 3, Tg greater than 2 ng/ml (20 patients). Main Outcome Measures: Tumor recurrence was measured. Results: In group 1, two of 62 patients (3%) with follow-up recurred. In group 2, 63% converted to group 1, whereas two of 19 (11%) converted to group 3 and then recurred. Sixteen of the initial 20 group 3 patients (80%) recurred, including recurrence rates of 69 and 100% for those with an initial rhTSH-Tg greater than 2.0 ng/ml but 5.0 ng/ml or less, and 4.6 ng/ml or greater, respectively. One group 3 patient died of distant metastases. rhTSH-Tg more accurately predicted tumor recurrence than basal Tg. An rhTSH-Tg threshold of 2.5 ng/ml or greater optimally predicted future recurrence with sensitivity, specificity, and negative and positive predictive values of 80, 97, 95, and 84%, respectively. Conclusions: The prevalence of postablation thyroid cancer recurrence is predicted by the rhTSH-Tg response with an optimal Tg threshold of 2.5 ng/ml. Still, recurrent disease occurs in some patients with an initial rhTSH-Tg of 0.5 ng/ml or less.

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In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽

10.1024/0301-1526/a000867 ◽

2020 ◽

Vol 49 (4) ◽

pp. 281-284

Author(s):

Atıf Yolgosteren ◽

Gencehan Kumtepe ◽

Melda Payaslioglu ◽

Cuneyt Ozakin

Keyword(s):

Vascular Graft ◽

Graft Infection ◽

Vascular Graft Infection ◽

Group 4 ◽

Significant Difference ◽

Group 3 ◽

Group 2 ◽

Prosthetic Vascular Graft Infection ◽

Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

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