scholarly journals Liquid Embolic Agents for Interventional Embolization

ChemPhysMater ◽  
2021 ◽  
Author(s):  
Yonghe Jiang ◽  
Yang Zhang ◽  
Zhixiang Lu ◽  
Xiaoyong Wang ◽  
Shuang Bai ◽  
...  
Keyword(s):  
Embolic Agents ◽  
Liquid Embolic

scholarly journals Emergency tips recanalisation and gastroesophageal varices embolisation with an ethylene vinyl alcohol copolymer agent (Squid) and detachable coils

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Massimo Venturini ◽  
Luigi Augello ◽  
Carolina Lanza ◽  
Marco Curti ◽  
Andrea Coppola ◽  
...  
Keyword(s):  
Therapeutic Option ◽  
Technical Note ◽  
Embolic Agent ◽  
Refractory Ascites ◽  
Gastroesophageal Varices ◽  
Ethylene Vinyl Alcohol ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Tube Removal ◽  
Detachable Coils

AbstractTransjugular intrahepatic portosystemic shunt (TIPS) is currently indicated as first therapeutic option in the main complications of portal hypertension, including bleeding gastroesophageal varices and refractory ascites. In case of bleeding gastroesophageal varices, an adjuvant embolisation within TIPS can be useful to prevent rebleeding. In the present technical note, the management in emergency of a patient with haemorrhagic shock due to bleeding gastroesophageal varices and occluded TIPS is reported. TIPS recanalisation with an adjunctive stent and high-pressure balloon angioplasty and gastroesophageal varices embolisation using detachable coils and a non-adhesive liquid embolic agent were performed during the same emergent procedure. After the procedure, clinical stabilisation of the patient was achieved, with blood transfusions suspension and Blakemore tube removal. At 6 months, regular TIPS patency at colour Doppler and no rebleeding episodes were recorded. To our knowledge, whilst coils are routinely used for varices embolisation, non-adhesive liquid embolic agents have been never mentioned. Liquid embolic agents seem to provide a stable plug strengthening the embolising action of the coils. Further studies involving a cohort of patients with long-term follow-up will be necessary to confirm whether this association can be more effective than coils alone in gastroesophageal varices embolisation.

scholarly journals Imaging artifacts of Onyx and PHIL on conventional CT, cone-beam CT and MRI in an animal model

2018 ◽  
Vol 24 (6) ◽  
pp. 693-701 ◽  
Author(s):  
Dominik F Vollherbst ◽  
Ruth Otto ◽  
Thuy Do ◽  
Hans U Kauczor ◽  
Martin Bendszus ◽  
...  
Keyword(s):  
Cone Beam Ct ◽  
Cone Beam ◽  
Embolic Agent ◽  
In Vivo Model ◽  
Ethylene Vinyl Alcohol ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Conventional Ct ◽  
Ct And Mri

Background and purpose A frequently reported drawback of ethylene vinyl alcohol copolymer-based liquid embolic agents is the production of artifacts in diagnostic imaging. New embolic agents, such as Precipitating hydrophobic injectable liquid (PHIL; MicroVention, Tustin, CA, USA), are supposed to induce significantly fewer artifacts. The purpose of this study is to assess the degree of artifacts induced by the liquid embolic agents Onyx (Medtronic Neurovascular, Irvine, CA, USA) and PHIL in conventional computed tomography (CT), cone-beam CT and magnetic resonance imaging (MRI) in an experimental in vivo model. Materials and methods In 10 pigs the rete mirabile was embolized with Onyx ( n = 5) or PHIL ( n = 5). After embolization, conventional CT, cone-beam CT and MRI were performed. The degree of artifacts was graded qualitatively (five-point scale; for CT and MRI) and quantitatively (HUs of well-defined regions of interest (ROIs); for CT only). Results Artifacts were significantly more severe for Onyx both in the qualitative (e.g. conventional CT: 2 versus 5 (medians); p = 0.008) and in the quantitative image analysis (e.g. cone-beam CT: standard deviation of a ROI near to the embolic agent cast, 94 HU versus 38 HU (medians); p = 0.008). Neither Onyx nor PHIL produced any apparent artifacts in MRI. Conclusion PHIL produces fewer artifacts than Onyx in conventional CT and cone-beam CT in an experimental in vivo model.

Republished: Multiplug flow control technique as a novel transarterial curative approach for the endovascular treatment of cerebrovascular malformations

2021 ◽  
pp. neurintsurg-2021-017418.rep
Author(s):  
H Saruhan Cekirge ◽  
Isil Saatci
Keyword(s):  
Flow Control ◽  
Dural Arteriovenous Fistula ◽  
Vascular Malformations ◽  
The Other ◽  
Control Technique ◽  
Injection Time ◽  
Complete Occlusion ◽  
Transarterial Embolisation ◽  
Embolic Agents ◽  
Liquid Embolic

Herein, we describe the use of a novel multiplug flow control technique for the curative transarterial embolisation of cerebrovascular malformations using liquid embolic agents (LEAs). The idea behind the use of this technique is to substantially control or arrest flow during LEA injection, with multiple plugs simultaneously formed from microcatheters that are placed within all or multiple feeders, so that the penetration of LEAs is facilitated, with flow control decreasing the washout of a malformation. This technique enables the complete occlusion of a vascular malformation in a shorter injection time than that in other methods because penetration is achieved faster. Details of this technique have been described in the treatment of two cases: one case of unruptured temporal arteriovenous malformation and in the other with a falcotentorial dural arteriovenous fistula, in which the vascular malformations were successfully occluded with transarterial embolisation.

scholarly journals The evolution of pre-operative spine tumour embolization

2019 ◽  
Vol 92 (1100) ◽  
pp. 20180899 ◽  
Author(s):  
Nima Omid-Fard ◽  
Charles G Fisher ◽  
Manraj KS Heran
Keyword(s):  
Case Series ◽  
Vascular Anatomy ◽  
Arteriovenous Shunting ◽  
Technical Parameters ◽  
Capillary Networks ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Fine Capillary ◽  
Spine Tumour ◽  
Tumour Characteristics

Pre-operative spine tumour embolization is a useful adjunct to minimize operative complications and blood loss during complex resections. While the efficacy of this procedure has been well studied, relatively little is documented regarding how to optimize technical parameters for tumour characteristics. This pictorial case series seeks to review our centre’s experience over the last decade in using a range of embolization techniques. As experience with this procedure has matured, we propose an approach based on the patient’s vascular anatomy and tumour angioarchitecture. This includes the use of coils as protective barriers rather than primary embolics; particle embolization to permeate fine capillary networks; consideration for liquid embolic agents in the presence of large caliber tumour vessels with associated arteriovenous shunting; and percutaneous intralesional embolization when endovascular access is insufficient to achieve the desired outcome. In many cases, a combination of these methods is needed, and close communication with the surgeon ensures the best outcome. Despite these advances, continued work is needed to determine how to optimize complete devascularization, and thus surgical benefit, while safely sparing critical neuroanatomical structures.

scholarly journals Liquid Embolic Agents in Spectral X-Ray Photon-Counting Computed Tomography using Tantalum K-Edge Imaging

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Isabelle Riederer ◽  
Daniel Bar-Ness ◽  
Melanie A. Kimm ◽  
Salim Si-Mohamed ◽  
Peter B. Noël ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Photon Counting ◽  
X Ray ◽  
Embolic Agents ◽  
Liquid Embolic

Management of direct carotid-cavernous sinus fistulas with the use of ethylene-vinyl alcohol (Onyx) only: preliminary results

2010 ◽  
Vol 112 (3) ◽  
pp. 595-602 ◽  
Author(s):  
Marco Zenteno ◽  
Jorge Santos-Franco ◽  
Vladimir Rodríguez-Parra ◽  
Jorge Balderrama ◽  
Yolanda Aburto-Murrieta ◽  
...  
Keyword(s):  
Case Series ◽  
Endovascular Techniques ◽  
Embolic Material ◽  
Ethylene Vinyl Alcohol ◽  
Sole Agent ◽  
Novel Approach ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Carotid Cavernous Fistulas

Object So-called direct carotid-cavernous fistulas (CCFs) are commonly treated by detachable balloons or coils to occlude the shunt while sparing the carotid artery. Liquid embolic agents have been rarely used, and in particular, to the authors' knowledge, the use of Onyx as the sole agent has never been reported in an indexed publication. Methods The authors describe a case series of 5 patients with posttraumatic CCF in whom embolization with Onyx was prospectively used as the sole strategy of management. Results Complete occlusion was obtained at the end of the procedure in 4 cases, and the lesion in the remaining patient subsequently occluded at the 6-month follow-up evaluation. Conclusions As endovascular techniques for treatment of direct CCFs continue to evolve, this novel approach with Onyx as the sole embolic material seems promising in treating these lesions.

scholarly journals Non-Adhesive Liquid Embolic Agents in Extra-Cranial District: State of the Art and Review of the Literature

2021 ◽  
Vol 10 (21) ◽  
pp. 4841
Author(s):  
Filippo Piacentino ◽  
Federico Fontana ◽  
Marco Curti ◽  
Edoardo Macchi ◽  
Andrea Coppola ◽  
...  
Keyword(s):  
State Of The Art ◽  
Case Reports ◽  
Meta Analysis ◽  
Review Of The Literature ◽  
Time Period ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Data Heterogeneity ◽  
New Generation

This review focuses on the use of “new” generation of non-adhesive liquid embolic agents (NALEA). In literature, non-adhesive liquid embolic agents have mainly been used in the cerebral district; however, multiple papers describing the use of NALEA in the extracranial district have been published recently and the aim of this review is to explore and analyze this field of application. There are a few NALEA liquids such as Onyx, Squid, and Phil currently available in the market, and they are used in the following applications: mainly arteriovenous malformations, endoleaks, visceral aneurysm or pseudoaneurysm, presurgical and hypervascular lesions embolization, and a niche of percutaneous approaches. These types of embolizing fluids can be used alone or in combination with other embolizing agents (such as coils or particles) so as to enhance its embolizing effect or improve its possible defects. The primary purpose of this paper is to evaluate the use of NALEAs, predominantly used alone, in elective embolization procedures. We did not attempt a meta-analysis due to the data heterogeneity, high number of case reports, and the lack of a consistent follow-up time period.

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