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.

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.

Balloon-assisted embolization of skull base meningioma with liquid embolic agent

2010 ◽  
Vol 112 (1) ◽  
pp. 70-72 ◽  
Author(s):  
Amr Abdel Kerim ◽  
Fabrice Bonneville ◽  
Betty Jean ◽  
Philippe Cornu ◽  
Lise LeJean ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Skull Base ◽  
Internal Carotid ◽  
Embolic Agent ◽  
Inflated Balloon ◽  
Novel Technique ◽  
Skull Base Meningioma ◽  
Small Branch ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

The authors report a novel technique of balloon-assisted embolization of a skull base meningioma supplied by a branch of the cavernous segment of the internal carotid artery using liquid embolic agent. A temporarily inflated balloon distal to the meningioma's feeding vessel may improve the access to this small branch and may reduce the chances of unintended reflux during delivery of the liquid embolic agent.

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.

scholarly journals Periorbital Inner Canthal Arteriovenous Malformations: Percutaneous Glue Embolization in Three Cases

2020 ◽  
Vol 4 (01) ◽  
pp. 55-59
Author(s):  
Krishnan Nagarajan ◽  
Arul A. S. Babu ◽  
Sekar Sabarish ◽  
Swamiappan Elango ◽  
Krishna Ramesh Babu ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Surgical Excision ◽  
High Flow ◽  
Embolic Agent ◽  
Cyanoacrylate Glue ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Glue Embolization ◽  
Attention To Detail

AbstractInner canthal or palpebral arteriovenous malformations (AVMs) are uncommon and difficult lesions to treat if they are of high-flow type. Though they may present with mainly cosmetic reasons, they derive feeders from the ophthalmic artery and are associated with dangerous anastomoses. Percutaneous liquid embolic agent has been used to treat various head and neck vascular malformations and tumors and, if done in meticulous attention to detail, can offer cure or control before surgical excision. We report three adults who presented with medial canthal swelling and on imaging diagnosed to have high-flow AVMs. They underwent percutaneous n-butyl cyanoacrylate (glue) embolization and subsequently operated to excise the embolized malformation without any blood loss or complications.

Treatment of experimental aneurysms with a new liquid embolic agent and a retrievable stent: proof of concept and feasibility study

2015 ◽  
Vol 8 (9) ◽  
pp. 934-939 ◽  
Author(s):  
Alejandro Berenstein
Keyword(s):  
Carotid Artery ◽  
Cerebral Aneurysms ◽  
Long Term Results ◽  
Embolic Agent ◽  
Embolic Material ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Partially Occluded ◽  
Treatment For Cerebral Aneurysms ◽  
Retrievable Stent

BackgroundOcclusion of canine bifurcation and sidewall aneurysms was undertaken with a new liquid embolic agent (PHIL 35) assisted by a high-density partially retrievable stent (FRED) with preservation of the carotid artery.MethodsThree dogs were used as acute preparations for development of the technique and two were used for chronic studies lasting 90 days. In one animal we intentionally did not completely fill the aneurysm to determine the long-term results of incomplete treatment. The degree of occlusion, carotid artery compromise, and dislodgement and/or migration of embolic material in treated aneurysms were assessed.ResultsAll aneurysms planned for complete obliteration were totally occluded successfully. By design, we partially occluded one aneurysm. In this aneurysm, angiography performed at 30 days revealed less filling, but at 90 days it had persistent small residual filling. We did not detect any distal embolization during the injection and no angiographic occlusions, change in configuration, or delayed migration of the embolic material were found. In the inspected stent, no foreign material was noted. In four animals we successfully removed the stent with preservation of the integrity of the carotid artery. In the fifth we intentionally left both stents deployed.ConclusionsWe have developed a new treatment for cerebral aneurysms using a combination of a retrievable stent and a new liquid embolic agent.

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

scholarly journals Re-treatment of residual aneurysms after flow diversion: An experimental study

2018 ◽  
Vol 31 (3) ◽  
pp. 270-279 ◽  
Author(s):  
Robert Fahed ◽  
Tim E Darsaut ◽  
Marc Kotowski ◽  
Igor Salazkin ◽  
Jean Raymond
Keyword(s):  
Flow Diverter ◽  
Artery Occlusion ◽  
Flow Diversion ◽  
Embolic Agent ◽  
Parent Artery ◽  
Arterial Lumen ◽  
Parent Artery Occlusion ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Flow Diverters

Aim Flow diverters are increasingly used to treat aneurysms, but treatment is not always effective. The management of aneurysms that fail to occlude following flow diversion is problematic. We aimed to reproduce failures in an animal model and study re-treatment with additional flow diverters alone or with flow diverters and liquid embolic agent. Material and methods Twenty wide-necked aneurysms were created at the carotid-lingual bifurcation in 10 dogs, and were treated with flow diverters 4–6 weeks later. Follow-up angiography was performed at three months. Suitable residual aneurysms were randomly allocated: re-treatment with flow diverters alone ( n = 6), or with the injection of liquid embolic between two layers of flow diverters ( n = 4) or no re-treatment ( n = 2). Angiography was repeated three months later, followed by euthanasia, photography and pathology. Results Patent wide-necked aneurysms were produced in 17/20 attempts (85%); three months after flow diversion there were 15/17 (88%) residual aneurysms. In three cases, re-treatment was not possible because the flow diverter had prolapsed into the aneurysm, leaving 12 aneurysms to study. Re-treated aneurysms showed improved angiographic results at six months (median score of 2; P = 0.03), but residual aneurysms were present in all cases. Parent artery occlusion occurred in two aneurysms treated with flow diverter plus liquid embolic. At pathology, aneurysms were only partially filled with thrombus; leaks through the flow diverters were found in the neointima connecting the arterial lumen to residual aneurysms. Conclusion Re-treatment of residual flow-diverted experimental aneurysms with additional flow diverters did not lead to aneurysm occlusion.

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