N-hexyl cyanoacrylate (NHCA) is a fast-polymerizing liquid embolic agent used in endovascular procedures to occlude blood vessels in the treatment of vascular malformations, such as arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs).
NHCA is a long-chain alkyl derivative of cyanoacrylate, composed of monomers that rapidly polymerize upon contact with ionic fluids (e.g., blood or saline), forming a solid cast within the vessel.
NHCA is part of the cyanoacrylate family of adhesives, differing from shorter-chain compounds (e.g., n-butyl cyanoacrylate, NBCA) by its:
Cyanoacrylates are fast-polymerizing liquid embolic agents used in endovascular procedures. The two most used types in neurointervention are:
→ Longer chains polymerize more slowly, allowing greater control.
→ NHCA is more forgiving during injection.
| Use Case | NBCA | NHCA |
|---|---|---|
| High-flow AVMs | ✅ | ⚠️ |
| Deep nidus penetration | ⚠️ | ✅ |
| Preoperative devascularization | ✅ | ✅ |
| Risky anatomy with tortuous feeders | ⚠️ | ✅ |
NHCA is used as a liquid embolic agent in:
In a retrospective single-center case series (n=22 patients, 24 procedures) with no control group or comparison, Murias Quintana et al. from the Hospital Universitario Central de Asturias, Oviedo, Hospital Clínic de Barcelona, Hospital Universitario Marqués de Valdecilla, Santander, Alfried Krupp Krankenhaus, Essen, Hospital Universitario de Salamanca 1) aim to describe outcomes after the use of N-hexyl cyanoacrylate (NHCA, “Magic Glue”) for AVM embolization. Despite its stated aim of evaluating “strengths and limitations,” the article offers a one-sided, promotional narrative that lacks critical analysis.
The journal *Cureus* is increasingly known for:
This paper reinforces that reputation, providing more of a procedural diary than a peer-reviewed study. It embodies editorial complacency and academic dilution.
A retrospective case series offers no comparative insight. There is:
This is not hypothesis-testing research — it’s purely observational, anecdotal reporting.
The paper defines technical success as “the outcome achieved based on objective.” This is circular reasoning and renders the concept of success meaningless.
Injection times and catheter models are listed with obsessive detail:
Yet none of these details translate to improved patient care or clinical insight.
No adverse events in 24 procedures cannot be extrapolated as “safe.” This cohort is underpowered to detect rare but serious complications — a classic false sense of security.
Only '3 out of 24 cases (12.5%)' achieved complete occlusion with a single NHCA injection. The authors still call it “effective.” This is an example of:
Frequent use of the term “Magic Glue” and positive adjectives for NHCA give this paper the tone of a product brochure, not a neutral scientific analysis.
Key omissions include:
This paper does not meet the standards of a rigorous scientific study. It provides:
It reinforces the perception of *Cureus* as a platform for uploading technically correct but scientifically irrelevant work. A procedural note disguised as research, this article is a missed opportunity to meaningfully contribute to the field of neurointerventional radiology.
Final Verdict: This is not a “study” — it is a technical anecdote polished with promotional language and framed in a journal that too often rewards upload volume over scientific substance.