scholarly journals Coil and Onyx embolization of a torcular herophili dural arteriovenous fistula in a full-term neonate with advanced heart failure using a transumbilical approach

2019 ◽  
Vol 23 (1) ◽  
pp. 80-85
Author(s):  
George W. Koutsouras ◽  
Redi Rahmani ◽  
Tyler Schmidt ◽  
Howard Silberstein ◽  
Tarun Bhalla
Keyword(s):  
Heart Failure ◽  
Severe Congestive Heart Failure ◽  
Full Term ◽  
Embolic Agent ◽  
Secondary Complications ◽  
Normal Birth ◽  
Arteriovenous Fistulas ◽  
Liquid Embolic ◽  
Life Threatening ◽  
Liquid Embolic Agent

Neonatal dural arteriovenous fistulas (DAVFs) are rare, but if left untreated will advance to life-threatening neurological and cardiovascular compromise. Endovascular treatment is the preferred treatment modality for DAVFs. The goal of endovascular therapy is to obliterate feeding vasculature and prevent secondary complications. Endovascular access can be difficult to obtain in a neonate. The authors present the case of a full-term, normal birth weight neonate with severe congestive heart failure secondary to a congenital DAVF of the torcular herophili that was successfully treated with transumbilical arterial coil embolization and a liquid embolic agent.

Preliminary experience with the liquid embolic material agent PHIL (Precipitating Hydrophobic Injectable Liquid) in treating cranial and spinal dural arteriovenous fistulas: technical note

2015 ◽  
Vol 8 (6) ◽  
pp. 596-602 ◽  
Author(s):  
Joe J Leyon ◽  
Swarupsinh Chavda ◽  
Allan Thomas ◽  
Saleh Lamin
Keyword(s):  
Interventional Neuroradiology ◽  
Technical Note ◽  
Embolic Agent ◽  
Embolic Material ◽  
Arteriovenous Fistulas ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Dural Arteriovenous Fistulas ◽  
Fluoroscopic Time ◽  
Liquid Embolic Agent

BackgroundLiquid embolic agents are the preferred embolic material in endovascular treatment of pial and brain arteriovenous malformations and dural arteriovenous fistulas (DAVFs). There is little choice available in interventional neuroradiology practice other than two of the most commonly used liquid embolic agents—n-butyl cyanoacrylate and the Onyx liquid embolic system (ev3 Neurovascular, Irvine, California, USA). PHIL (Precipitating Hydrophobic Injectable Liquid) (Microvention, Inc California, USA) is a new liquid embolic agent, CE marked and available for clinical use in Europe.ObjectiveTo present our preliminary experience using PHIL in treating cranial and spinal DAVFs.MethodsBetween September 2014 and January 2015, eight patients, with five cranial DAVFs and three spinal DAVFs were treated with PHIL as the sole embolic agent used with intent to cure. Clinical presentation, location of DAVF, Borden type, fluoroscopic time, radiation dose, procedural time, injecting microcatheter used, volume of PHIL injected, complications, immediate angiographic data, premorbid and discharge modified Rankin Scale score, and any neurologic deficits were included in the analysis.ResultsSeven patients were successfully treated with complete angiographic exclusion of the fistula in a single sitting. Treatment failed in one patient where only suboptimal microcatheter positioning could be achieved and PHIL failed to penetrate the fistula's nidus. Venous penetration was achieved in all other patients except one with a small fistula, but with adequate fistula penetration by the embolic material. No other technical complication or neurologic deterioration occurred in any of the patients.ConclusionsPHIL liquid embolic agent appears to be an excellent alternative embolic material with certain advantages compared with other available liquid embolic agents. Further studies are required to fully evaluate its safety and efficacy.

scholarly journals Precipitating hydrophobic injectable liquid embolization of intracranial vascular shunts: initial experience and technical note

2018 ◽  
Vol 129 (5) ◽  
pp. 1217-1222 ◽  
Author(s):  
Shriram Varadharajan ◽  
Arvinda Hanumanthapura Ramalingaiah ◽  
Jitender Saini ◽  
Arun Kumar Gupta ◽  
B. Indira Devi ◽  
...  
Keyword(s):  
Endovascular Embolization ◽  
Technical Note ◽  
Embolic Agent ◽  
Arteriovenous Fistulas ◽  
Embolic Agents ◽  
Liquid Embolic ◽  
Complete Obliteration ◽  
Liquid Embolic Agent ◽  
Pial Arteriovenous Fistula

Precipitating hydrophobic injectable liquid (PHIL) is a newly available liquid embolic agent for endovascular therapy. It is nonadhesive and composed of a biocompatible polymer dissolved in dimethyl sulfoxide solvent and bonded covalently with iodine.In this report, the authors present their preliminary experience using PHIL in the treatment of intracranial vascular shunts. Between July 2015 and December 2015, 11 patients underwent endovascular embolization using the PHIL embolic agent. Five patients had arteriovenous malformations, 4 had dural arteriovenous fistulas, 1 patient had a carotid-cavernous fistula, and 1 patient had a pial arteriovenous fistula. Clinical features, angioarchitectural characteristics, procedural details, and periprocedural complications were included in the analysis.Complete or near-complete obliteration of the nidus or fistulas was achieved in 8 of these patients. Partial embolization (approximately 80% in 2 and 30% in 1) was attained in the other 3 patients. Satisfactory venous penetration after nidal embolization was achieved in all patients. In 1 patient, the microcatheter could not be retrieved. No other major complications related to PHIL injection were noted during the procedure or periprocedural period. Clinical follow-up ranging from 8 months to 1 year showed good outcomes in all but 1 patient, who experienced an intraventricular hemorrhage 6 weeks after embolization.PHIL appears to be an effective alternative embolic material with certain advantages over other available liquid embolic agents. Further studies with adequate follow-up are required to fully evaluate its safety and efficacy.

scholarly journals Giant Hepatic Artery Aneurysm Associated with Immunoglobulin G4-Related Disease Successfully Treated Using a Liquid Embolic Agent

2015 ◽  
Vol 16 (4) ◽  
pp. 953 ◽  
Author(s):  
Michele Rossi ◽  
Edoardo Virgilio ◽  
Florindo Laurino ◽  
Gianluigi Orgera ◽  
Paolo Menè ◽  
...  
Keyword(s):  
Hepatic Artery ◽  
Artery Aneurysm ◽  
Embolic Agent ◽  
Hepatic Artery Aneurysm ◽  
Immunoglobulin G4 ◽  
Related Disease ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

scholarly journals Investigation of a New Version of the Liquid Embolic Agent PHIL with Extra-Low-Viscosity in an Endovascular Embolization Model

2018 ◽  
Vol 39 (9) ◽  
pp. 1696-1702 ◽  
Author(s):  
D.F. Vollherbst ◽  
R. Otto ◽  
M. Hantz ◽  
C. Ulfert ◽  
H.U. Kauczor ◽  
...  
Keyword(s):  
Endovascular Embolization ◽  
Embolic Agent ◽  
Low Viscosity ◽  
Liquid Embolic ◽  
Liquid Embolic Agent
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