scholarly journals In Vivo Assessment of Chitosan/β-Glycerophosphate as a New Liquid Embolic Agent

2011 ◽  
Vol 17 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Y. Wang ◽  
N. Xu ◽  
Q. Luo ◽  
Y. Li ◽  
L. Sun ◽  
...  
Keyword(s):  
Renal Arteries ◽  
Embolic Agent ◽  
Inflammatory Reactions ◽  
Complete Occlusion ◽  
Liquid Embolic ◽  
Feasibility Evaluation ◽  
Liquid Embolic Agent ◽  
In Vivo Assessment

We sought to assess the feasibility of using thermosensitive chitosan/β-glycerophosphate for embolotherapy. The renal arteries in nine rabbits were embolized with chitosan/β-glycerophosphate. The animals were studied angiographically and sacrificed at one week (n = 3), four weeks (n = 3), and eight weeks (n = 3) after embolotherapy. Histology was obtained at these three time points. Delivery of chitosan/β-glycerophosphate was successful in all cases. Complete occlusion was achieved in all cases. No recanalization was observed in the follow-up angiograms. No untoward inflammatory reactions were observed in the target renal arteries and infarcted kidneys during the histological examinations. Our preliminary feasibility evaluation in rabbit renal arteries indicates that C/GP is a satisfactory embolization agent.

Combined transarterial N-butyl cyanoacrylate and coil embolization of direct carotid–cavernous fistulas

2007 ◽  
Vol 106 (5) ◽  
pp. 903-906 ◽  
Author(s):  
Neil A. Troffkin ◽  
Curtis A. Given
Keyword(s):  
Carotid Artery ◽  
Coil Embolization ◽  
Nerve Palsy ◽  
Embolic Agent ◽  
Cyanoacrylate Glue ◽  
Complete Occlusion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Carotid Cavernous Fistulas ◽  
Complex Cases

✓ The authors report two cases of traumatic carotid–cavernous fistulas treated successfully with combined N-butyl cyanoacrylate glue and coil embolization via a transarterial approach. In both cases complete occlusion of the fistula was achieved, with preservation of the parent carotid artery. Casting of the cavernous sinus with a liquid embolic agent was well tolerated and produced no complications of cranial nerve palsy. This technique provides interventionalists with yet another treatment option in these often complex cases.

Evaluation of a novel liquid embolic agent (precipitating hydrophobic injectable liquid (PHIL)) in an animal endovascular embolization model

2017 ◽  
Vol 10 (3) ◽  
pp. 268-274 ◽  
Author(s):  
Dominik F Vollherbst ◽  
Ruth Otto ◽  
Andreas von Deimling ◽  
Johannes Pfaff ◽  
Christian Ulfert ◽  
...  
Keyword(s):  
Waiting Time ◽  
Transarterial Embolization ◽  
Endovascular Embolization ◽  
Embolic Agent ◽  
Rete Mirabile ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Group Survival

BackgroundThe choice of the embolic agent and the embolization technique can have a significant impact on the success of endovascular embolization.ObjectiveTo evaluate a novel iodinated copolymer-based liquid embolic agent (precipitating hydrophobic injectable liquid (PHIL)) in the porcine rete mirabile (RM), serving as an endovascular embolization model. Onyx, as an established liquid embolic agent, served as comparator.Materials and methodsSixteen embolization procedures were performed using PHIL (n=8) or Onyx (n=8) as liquid embolic agent. Waiting time between injections was set to 30 or 60 s (n=4 per study group). Survival time after intervention was 2 hours or 7 days. Embolization characteristics (eg, procedure times, number of injections and volume of embolic agent) and embolization extent (percentage of embolized RM in post-interventional x-ray) were assessed. Post-interventional CT and histopathological analyses were performed.ResultsEmbolization characteristics and embolization extent were not significantly different for PHIL and Onyx, including subgroups (eg, embolization extent 44% vs 69% (medians); p=0.101). For PHIL, extension of the waiting time from 30 to 60 s led to a significantly higher embolization extent (24% vs 72% (medians); p=0.035). Moderate disintegration and mild inflammation of the embolized blood vessels were present for both embolic agents.ConclusionPHIL is feasible for transarterial embolization in an acute and subacute endovascular embolization model. In this preliminary experimental in vivo study, embolization characteristics, embolization extent, and biocompatibility seem to be similar to those of Onyx.

Republished: Resolution of an enlarging subdural haematoma after contralateral middle meningeal artery embolisation

2021 ◽  
pp. neurintsurg-2021-017530.rep
Author(s):  
Caleb Rutledge ◽  
Jacob F Baranoski ◽  
Joshua S Catapano ◽  
Ashutosh P Jadhav ◽  
Felipe C Albuquerque ◽  
...  
Keyword(s):  
Subdural Haematoma ◽  
Mass Effect ◽  
Middle Meningeal Artery ◽  
Embolic Agent ◽  
Head Ct ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
The Right ◽  
Meningeal Artery

A man in his 50s presented 1 month after an automobile accident with worsening headaches and an enlarging chronic left subdural haematoma (SDH). He underwent left middle meningeal artery (MMA) embolisation. Due to tortuosity at its origin, we were unable to catheterise the MMA distally. Only proximal coil occlusion at the origin was performed. Follow-up interval head CT showed an increase in the size of the SDH with new haemorrhage, worsening mass effect and midline shift. However, he remained neurologically intact. Contralateral embolisation of the right MMA was performed with a liquid embolic agent. His headaches improved, and a follow-up head CT 3 months later showed near-complete resolution of the SDH.

Intrasaccular combination of metallic coils and Onyx liquid embolic agent for the endovascular treatment of cerebral aneurysms

2006 ◽  
Vol 105 (5) ◽  
pp. 706-712 ◽  
Author(s):  
H. Saruhan Cekirge ◽  
Isil Saatci ◽  
Serdar Geyik ◽  
Kivilcim Yavuz ◽  
Halil Öztürk ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysms ◽  
Embolic Agent ◽  
Stent Insertion ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Embolic Coils

Object The aim of this study was to report on a novel technique in which metallic embolization coils were combined with the Onyx liquid embolic agent in the aneurysm sac to achieve a more durable result after endovascular treatment. This therapeutic procedure was performed in selected cases in which, based on the authors’ experiences, either coil embolization or Onyx alone would likely have failed. The authors report long-term clinical and angiographic follow-up results in 20 consecutive intracranial aneurysms treated using this combination for defined indications. Methods Twenty aneurysms in 20 patients were treated with a combination of embolic coils and Onyx. Four aneurysms were giant; 13, large; and three, small. This new technique was used when standard Onyx or coil treatment with balloon assistance was determined to involve a higher possibility of recanalization, because either an adjunctive stent insertion could not be performed or the Onyx technique could not be used due to an unsuccessful seal test or intraaneurysm balloon prolapse. In one case, an adjunctive stent was placed before coil placement and Onyx deposition to control the material in the sac of the aneurysm, which had a fusiform neck. All aneurysms were completely occluded after using this technique. No clinical or technical adverse events occurred in any of the cases. Follow-up angiography was performed in all patients: 3-year studies in six patients, 2-year studies in five, and 1-year studies in nine. None of these studies demonstrated aneurysm regrowth or parent artery occlusion. Conclusions The combination of the embolic coils and the Onyx liquid embolic agent provides very durable aneurysm occlusion for defined indications.

The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: a novel technique using Onyx

2012 ◽  
Vol 32 (5) ◽  
pp. E13 ◽  
Author(s):  
Nohra Chalouhi ◽  
Aaron S. Dumont ◽  
Stavropoula Tjoumakaris ◽  
L. Fernando Gonzalez ◽  
Jurij R. Bilyk ◽  
...  
Keyword(s):  
Treatment Option ◽  
Primary Treatment ◽  
Embolic Agent ◽  
Superior Ophthalmic Vein ◽  
Type D ◽  
Liquid Embolic ◽  
Complete Obliteration ◽  
Liquid Embolic Agent ◽  
Carotid Cavernous Fistulas

Object Endovascular therapy is the primary treatment option for carotid-cavernous fistulas (CCFs). Operative cannulation of the superior ophthalmic vein (SOV) provides a reasonable alternative route to the cavernous sinus when all transvenous and transarterial approaches have been unsuccessful. The role of the liquid embolic agent Onyx in the management of CCFs has not been well documented, especially when using an SOV approach. The purpose of this study is to assess the safety and efficacy of Onyx embolization of CCFs through a surgical cannulation of the SOV. Methods The authors retrospectively reviewed all patients with CCFs who were treated with Onyx through an SOV approach between April 2009 and April 2011. Traditional endovascular approaches had failed in all patients. Results A total of 10 patients were identified, 1 with a Type A CCF, 5 with a Type B CCF, and 4 with a Type D CCF. All fistulas were embolized in 1 session. Onyx was the sole embolic agent used in 7 cases and was combined with coils in 3 other cases. Complete obliteration was achieved in 8 patients and a significant reduction in fistulous flow was achieved in 2 patients, which later progressed to near-complete occlusion on angiographic follow-up. All patients experienced a complete clinical recovery with excellent cosmetic results and were free from recurrence at their latest clinical follow-up evaluations. Conclusions Onyx embolization is an excellent therapy for CCFs in general, and through an SOV approach in particular. Direct operative cannulation of the SOV followed by Onyx embolization may be the best treatment option in patients with CCFs when all other endovascular approaches have been exhausted.

ENDOVASCULAR TREATMENT OF EXPERIMENTAL ANEURYSMS USING A COMBINATION OF THERMOREVERSIBLE GELATION POLYMER AND PROTECTION DEVICES

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 601-609 ◽  
Author(s):  
Hiroyuki Takao ◽  
Yuichi Murayama ◽  
Ichiro Yuki ◽  
Toshihiro Ishibashi ◽  
Masaki Ebara ◽  
...  
Keyword(s):  
Mechanical Stability ◽  
Side Wall ◽  
Embolic Agent ◽  
Experimental Aneurysm ◽  
Aneurysm Embolization ◽  
Liquid Embolic ◽  
Thermoreversible Gelation ◽  
Liquid Embolic Agent ◽  
Thermoreversible Gelation Polymer

Abstract OBJECTIVE We developed a new liquid embolic agent, an aqueous solution of thermoreversible gelation polymer (TGP) for the treatment of cerebral aneurysms. This polymer solution has the unique characteristics that allow it to solidify at a specific temperature without solvent. We performed an experimental aneurysm embolization using this liquid embolic agent with and without different protective devices to evaluate its technical feasibility for the treatment of aneurysms. METHODS Fourteen side-wall aneurysms were surgically constructed on 14 common carotid arteries of 7 swine. Embolizations were conducted in combination with balloon protection (balloon group, n = 4), microstent protection (stent group, n = 4), and microcoil and microstent protection (stent-coil group, n = 4). Two aneurysms were used as controls. One control aneurysm was not embolized, and the other received control stent placement only. Angiographic follow-up was performed on day 14 and was followed by histopathological evaluation. RESULTS Successful TGP solution delivery was conducted in all cases. Complete aneurysm occlusion was achieved in all cases without TGP migration. Follow-up angiograms demonstrated complete occlusion in the stent and stent-coil groups. A small recurrence was observed in the balloon group. Histopathological findings demonstrated neoendothelialization across the necks of the aneurysms. CONCLUSION Experimental aneurysms were safely embolized using TGP. Further modifications related to mechanical stability and long-term safety evaluation results are necessary before clinical application.

Embolization of spinal intramedullary arteriovenous malformations using the liquid embolic agent, Onyx: a single-center experience in a series of 17 patients

2007 ◽  
Vol 7 (5) ◽  
pp. 478-485 ◽  
Author(s):  
Rufus A. Corkill ◽  
Aristotelis P. Mitsos ◽  
Andrew J. Molyneux
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Signs And Symptoms ◽  
Treatment Method ◽  
Embolic Agent ◽  
Functional Evaluation ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

Object The aim of this study was to analyze the endovascular treatment results of using the Onyx liquid embolic system for spinal intramedullary arteriovenous malformations (AVMs). Methods The clinical and radiological records of 17 patients with symptomatic spinal intramedullary AVMs treated exclusively by embolization with Onyx between 1999 and 2003 were retrospectively reviewed. There were 12 females and five males in the patient series (mean age 29 years). Four of these AVMs were located in the cervical spine, eight in the thoracic spine, and five in the lumbar spine. The clinical presentation of these AVMs included upper motor neuron signs and symptoms, and hemorrhage was the initial presentation in 12 patients. Neurological and functional evaluation was performed before and after treatment with Onyx in all patients. Results Thirteen patients underwent a single endovascular treatment and four patients underwent two endovascular treatments (average 1.23 sessions per patient). Intraprocedural complications occurred on two occasions without neurological consequences. The mean follow-up duration was 24.3 months. Angiographic outcomes included total AVM obliteration in six patients (37.5%), subtotal obliteration in five patients (31.25%), and partial obliteration in five patients (31.25%). Improvement in neurological and/or functional status was noted in 14 patients, resulting in an 82% rate of overall good clinical outcome. Conclusions Embolization using the Onyx system is a promising treatment method for spinal vascular malformations, even for challenging intramedullary AVMs. Larger studies with longer follow-up durations will further enhance our knowledge on the safety and efficacy of this relatively new liquid embolic agent.

Resolution of an enlarging subdural haematoma after contralateral middle meningeal artery embolisation

2021 ◽  
Vol 14 (4) ◽  
pp. e017530
Author(s):  
Caleb Rutledge ◽  
Jacob F Baranoski ◽  
Joshua S Catapano ◽  
Ashutosh P Jadhav ◽  
Felipe C Albuquerque ◽  
...  
Keyword(s):  
Subdural Haematoma ◽  
Mass Effect ◽  
Middle Meningeal Artery ◽  
Embolic Agent ◽  
Head Ct ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
The Right ◽  
Meningeal Artery

A man in his 50s presented 1 month after an automobile accident with worsening headaches and an enlarging chronic left subdural haematoma (SDH). He underwent left middle meningeal artery (MMA) embolisation. Due to tortuosity at its origin, we were unable to catheterise the MMA distally. Only proximal coil occlusion at the origin was performed. Follow-up interval head CT showed an increase in the size of the SDH with new haemorrhage, worsening mass effect and midline shift. However, he remained neurologically intact. Contralateral embolisation of the right MMA was performed with a liquid embolic agent. His headaches improved, and a follow-up head CT 3 months later showed near-complete resolution of the SDH.

scholarly journals Eyelid arteriovenous malformation treated with pre-surgical embolization: A case report

2018 ◽  
Vol 24 (3) ◽  
pp. 327-330 ◽  
Author(s):  
Robert Juszkat ◽  
Bartosz Żabicki ◽  
Katarzyna Stanistawska ◽  
Karolina Szepelak ◽  
Bartosz Kądziołka ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Transarterial Embolization ◽  
Embolic Agent ◽  
Clinical Aspects ◽  
Multiple Time ◽  
Selective Embolization ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

Background Arteriovenous malformations are potentially serious vascular anomalies that are rarely encountered in the eyelid and require a multidisciplinary approach. Objectives We would like to describe the technical and clinical aspects related to the treatment of palpebral arteriovenous malformation with selective embolization, followed by surgical resection. Methods A 40-year-old patient presented with an isolated high-flow palpebral arteriovenous malformation. Transarterial embolization, using a liquid embolic agent (PHIL™), was performed in this patient. Results Angiographic and clinical follow-up revealed good results with clinical regression of the mass. Conclusion Although endovascular treatment of palpebral arteriovenous malformations is technically challenging, good functional and cosmetic result was achieved. Arteriovenous malformation embolization using PHIL™ seems to be very effective and makes subsequent surgical procedure safe and feasible. Level IV Evidence obtained from multiple time series with or without the intervention, such as case studies. Dramatic results in uncontrolled trials might also be regarded as this type of evidence.

The dual microcatheter technique for transvenous embolization of dural arteriovenous fistulae

2016 ◽  
Vol 9 (6) ◽  
pp. 578-582 ◽  
Author(s):  
Isaac Josh Abecassis ◽  
John D Nerva ◽  
Basavaraj V Ghodke ◽  
Laligam N Sekhar ◽  
Michael R Levitt ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Embolic Agent ◽  
Transvenous Embolization ◽  
Arteriovenous Fistulae ◽  
Liquid Embolic ◽  
Complete Obliteration ◽  
Liquid Embolic Agent ◽  
Cerebral Venous Drainage ◽  
Distal Aspect

BackgroundDural arteriovenous fistulae (dAVFs) comprise 10–15% of all intracranial arteriovenous malformations. The goal of surgical or endovascular intervention is complete obliteration of the fistulous connection(s). In cases where dAVF venous drainage is separate from normal cortical drainage, transvenous embolization can provide fast and effective fistula obliteration.ObjectiveTo describe a new method of efficient transvenous embolization (the ‘dual microcatheter technique’) for the treatment of dAVFs.MethodsThree patients with dAVFs were treated using the dual microcatheter technique for transvenous embolization. Two microcatheters were placed in the distal aspect of the dAVF venous pouch, after which coil embolization reduced fistula flow, and liquid embolic agent injection with reflux into arterial feeders completed the obliteration of the fistula.ResultsLesion grade ranged from Borden–Shucart grades 2 through 3. In all cases, dAVF venous drainage was isolated from the normal cerebral venous drainage. Dual microcatheter transvenous embolization was successful in all patients, with non-target embolization and no new postoperative deficits. At the last follow-up, all three patients were symptom-free without evidence of radiographic recurrence.ConclusionsThe dual microcatheter technique of transvenous dAVF embolization is safe and feasible in cases where dAVF venous outflow is isolated from normal cerebral venous drainage.

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