PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

Cheung, Eric F.C.; Ng, Rebecca Yuen Ting; Yu, Simon C.H.; Zhuang, James Tin Fong; Wong, George Kwok Chu

doi:10.5469/neuroint.2022.00199

Cited by 7 publications

(6 citation statements)

References 26 publications

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“…Table 1 summarizes the liquid embolics that are discussed in this review. Shear-Thinning Biomaterials [88,89] Silk Elastin Protein (SELP) [90][91][92] Poly(Ethylene Glycol) Hydrogel Embolization System (HES) Instylla Embrace [92][93][94][95][96] Eudragit [97][98][99][100] Calcium Alginate [101][102][103][104][105][106] Ethylene vinyl alcohol copolymers Squid and Squid Peri [107][108][109][110][111][112][113][114][115][116][117] Onyx Poly(lactide-co-glycolide) and poly(hydroxyethyl methacrylate) PHIL [159][160][161][162][163][164][165][166][167] Iodinated polyvinyl alcohol EASYX [168][169][170][171] 3.1. Polymerizing Liquid Embolics…”

Section: Liquid Embolicsmentioning

confidence: 99%

Liquid Embolic Agents for Endovascular Embolization: A Review

Pal

Blanzy

Gómez

et al. 2023

Gels

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Endovascular embolization (EE) has been used for the treatment of blood vessel abnormalities, including aneurysms, AVMs, tumors, etc. The aim of this process is to occlude the affected vessel using biocompatible embolic agents. Two types of embolic agents, solid and liquid, are used for endovascular embolization. Liquid embolic agents are usually injectable and delivered into the vascular malformation sites using a catheter guided by X-ray imaging (i.e., angiography). After injection, the liquid embolic agent transforms into a solid implant in situ based on a variety of mechanisms, including polymerization, precipitation, and cross-linking, through ionic or thermal process. Until now, several polymers have been designed successfully for the development of liquid embolic agents. Both natural and synthetic polymers have been used for this purpose. In this review, we discuss embolization procedures with liquid embolic agents in different clinical applications, as well as in pre-clinical research studies.

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Section: Liquid Embolicsmentioning

confidence: 99%

Liquid Embolic Agents for Endovascular Embolization: A Review

Pal

Blanzy

Gómez

et al. 2023

Gels

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“…Subsequently, its use was also consolidated in the extracranial district, mainly for AVMs, bronchial and pulmonary arteries, endoleaks, visceral aneurysms and pseudoaneurysms, hypervascular tumors and venous embolizations [24][25][26][27][28][29][30][31][32]. Squid has been used mainly in the cerebral district [23,33] with some recent applications in the extracranial district [34][35][36].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs) in Transcatheter Arterial Embolization (TAE) of Acute Non-Neurovascular Bleeding: A Multicenter Retrospective Cohort Study

et al. 2023

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Background and Objectives: Transcatheter arterial embolization (TAE) is part of the daily practice of most interventional radiologists worldwide. The ideal liquid embolic agent is far from being identified. Non-adhesive liquid embolic agents (NALEA) harden from the outside to the inside, resulting in deep penetration, known as “magma-like” progression, which permits a more distal embolization with good control of the embolic material. This multicenter retrospective cohort study aims to assess the efficacy, feasibility and safety of transcatheter arterial embolization (TAE) with ethylene-vinyl alcohol (EVOH)-based NALEAs (Onyx and Squid) in acute bleeding outside of the neurovascular area. Materials and Methods: This study is a multicenter analysis of retrospectively collected data of consecutive patients who had undergone, from January 2015 to December 2022, transcatheter arterial embolization with non-adhesive EVOH-based agents in the setting of acute non-neurovascular bleeding. Results: Fifty-three patients underwent transcatheter arterial embolization for acute non-neurovascular bleeding. Eight (15.1%) procedures were performed in patients with coagulopathy. The most used concentration of EVOH-based NALEAs was 34 (i.e., 8%), with a mean dose of 0.5 (±0.3) mL. The mean CT-to-groin time, the mean procedure time, the mean CT-to-embolization time and the mean fluoroscopy time were 22.9 (±12.4) min, 27.5 (±7) min, 50.3 (±13.1) min and 7.5 (±2.8) min, respectively. Technical success was achieved in all cases with a 96.2% clinical success rate. Complications were recorded in six (11.3%) patients. No statistically significant differences were observed between the group of patients with coagulopathy and the group of patients without coagulopathy in terms of efficacy and safety endpoints. Conclusions: Transcatheter arterial embolization (TAE) performed with non-adhesive EVOH-based embolic agents is an effective, feasible and safe strategy for the management of acute non-neurovascular bleeding, even in the subgroup of patients with coagulopathy.

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“…Male sex and unruptured or right-sided BAVMs were associated with improved functional outcomes. 14 In our case series, 44% of the BAVMs were right-sided, and 40% were unruptured. Due to the retrospective nature of the study, the modified Rankin score was unavailable for most cases.…”

Section: Discussionmentioning

confidence: 56%

“…However, Onyx, Squid, and PHIL occlusion rates vary, likely due to different protocols, intent of embolization, and AVM morphology at different centers. 14 …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Embolization of brain arteriovenous malformations with squid co-polymer embolic material: Initial experience

Ch'ng,

Zaki,

Sobri Muda

2023

Journal of Interventional Medicine

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PHIL and Squid Embolization of Cerebral Arteriovenous Malformation: A Retrospective Case Series of 23 Patients

Cited by 7 publications

References 26 publications

Liquid Embolic Agents for Endovascular Embolization: A Review

Liquid Embolic Agents for Endovascular Embolization: A Review

Efficacy and Safety of Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs) in Transcatheter Arterial Embolization (TAE) of Acute Non-Neurovascular Bleeding: A Multicenter Retrospective Cohort Study

Embolization of brain arteriovenous malformations with squid co-polymer embolic material: Initial experience

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