Glue, Onyx, Squid or PHIL? Liquid Embolic Agents for the Embolization of Cerebral Arteriovenous Malformations and Dural Arteriovenous Fistulas.
Embolic agents
Embolization
Hemorrhagic stroke
Interventional neuroradiology
Vascular malformation
Journal
Clinical neuroradiology
ISSN: 1869-1447
Titre abrégé: Clin Neuroradiol
Pays: Germany
ID NLM: 101526693
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
received:
20
05
2021
accepted:
01
07
2021
pubmed:
30
7
2021
medline:
8
3
2022
entrez:
29
7
2021
Statut:
ppublish
Résumé
Endovascular embolization is an effective treatment option for cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs). A variety of liquid embolic agents have been and are currently used for embolization of AVMs and DAVFs. Knowledge of the special properties of the agent which is used is crucial for an effective and safe embolization procedure. This article describes the properties and indications of the liquid embolic agents which are currently available: cyanoacrylates (also called glues), and the copolymers Onyx, Squid and PHIL, as well as their respective subtypes. Cyanoacrylates were the predominantly used agents in the 1980s and 1990s. They are currently still used in specific situations, for example for the occlusion of macro-shunts, for the pressure cooker technique or in cases in which microcatheters are used that are not compatible with dimethyl-sulfoxide. The first broadly used copolymer-based embolic agent Onyx benefits from a large amount of available experience and data, which demonstrated its safety and efficacy in the treatment of cerebral vascular malformations, while its drawbacks include temporary loss of visibility during longer injections and artifacts in cross-sectional imaging. The more recently introduced agents Squid and PHIL aim to overcome these shortcomings and to improve the success rate of endovascular embolization. Novelties of these newer agents with potential advantages include extra-low viscosity versions, more stable visibility, and a lower degree of imaging artifacts. All the available liquid embolic agents feature specific potential advantages and disadvantages over each other. The choice of the most appropriate embolic agent must be made based on the specific material characteristics of the agent, related to the specific anatomical characteristics of the target pathology.
Sections du résumé
BACKGROUND
BACKGROUND
Endovascular embolization is an effective treatment option for cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs). A variety of liquid embolic agents have been and are currently used for embolization of AVMs and DAVFs. Knowledge of the special properties of the agent which is used is crucial for an effective and safe embolization procedure.
MATERIAL AND METHODS
METHODS
This article describes the properties and indications of the liquid embolic agents which are currently available: cyanoacrylates (also called glues), and the copolymers Onyx, Squid and PHIL, as well as their respective subtypes.
RESULTS
RESULTS
Cyanoacrylates were the predominantly used agents in the 1980s and 1990s. They are currently still used in specific situations, for example for the occlusion of macro-shunts, for the pressure cooker technique or in cases in which microcatheters are used that are not compatible with dimethyl-sulfoxide. The first broadly used copolymer-based embolic agent Onyx benefits from a large amount of available experience and data, which demonstrated its safety and efficacy in the treatment of cerebral vascular malformations, while its drawbacks include temporary loss of visibility during longer injections and artifacts in cross-sectional imaging. The more recently introduced agents Squid and PHIL aim to overcome these shortcomings and to improve the success rate of endovascular embolization. Novelties of these newer agents with potential advantages include extra-low viscosity versions, more stable visibility, and a lower degree of imaging artifacts.
CONCLUSION
CONCLUSIONS
All the available liquid embolic agents feature specific potential advantages and disadvantages over each other. The choice of the most appropriate embolic agent must be made based on the specific material characteristics of the agent, related to the specific anatomical characteristics of the target pathology.
Identifiants
pubmed: 34324005
doi: 10.1007/s00062-021-01066-6
pii: 10.1007/s00062-021-01066-6
pmc: PMC8894162
doi:
Substances chimiques
Polyvinyls
0
Dimethyl Sulfoxide
YOW8V9698H
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
25-38Informations de copyright
© 2021. The Author(s).
Références
Pierot L, Cognard C, Herbreteau D, Fransen H, van Rooij WJ, Boccardi E, Beltramello A, Sourour N, Kupcs K, Biondi A, Bonafé A, Reith W, Casasco A. Endovascular treatment of brain arteriovenous malformations using a liquid embolic agent: results of a prospective, multicentre study (BRAVO). Eur Radiol. 2013;23:2838–45.
doi: 10.1007/s00330-013-2870-6
pubmed: 23652849
Gross BA, Albuquerque FC, Moon K, McDougall CG. Evolution of treatment and a detailed analysis of occlusion, recurrence, and clinical outcomes in an endovascular library of 260 dural arteriovenous fistulas. J Neurosurg. 2017;126:1884–93.
doi: 10.3171/2016.5.JNS16331
pubmed: 27588586
Nataraj A, Mohamed MB, Gholkar A, Vivar R, Watkins L, Aspoas R, Gregson B, Mitchell P, Mendelow AD. Multimodality treatment of cerebral arteriovenous malformations. World Neurosurg. 2014;82:149–59.
doi: 10.1016/j.wneu.2013.02.064
pubmed: 23454686
Sadeh-Gonike U, Magand N, Armoiry X, Riva R, Labeyrie PE, Lamy B, Lukaszewicz AC, Lehot JJ, Turjman F, Gory B. Transarterial Onyx Embolization of Intracranial Dural Fistulas: A Prospective Cohort, Systematic Review, and Meta-Analysis. Neurosurgery. 2018;82:854–63.
doi: 10.1093/neuros/nyx309
pubmed: 29351648
Elsenousi A, Aletich VA, Alaraj A. Neurological outcomes and cure rates of embolization of brain arteriovenous malformations with n-butyl cyanoacrylate or Onyx: a meta-analysis. J Neurointerv Surg. 2016;8:265–72.
doi: 10.1136/neurintsurg-2014-011427
pubmed: 25540177
Sorimachi T, Koike T, Takeuchi S, Minakawa T, Abe H, Nishimaki K, Ito Y, Tanaka R. Embolization of cerebral arteriovenous malformations achieved with polyvinyl alcohol particles: angiographic reappearance and complications. AJNR Am J Neuroradiol. 1999;20:1323–8.
pubmed: 10472993
pmcid: 7055976
Chapot R, Stracke P, Velasco A, Nordmeyer H, Heddier M, Stauder M, Schooss P, Mosimann PJ. The pressure cooker technique for the treatment of brain AVMs. J Neuroradiol. 2014;41:87–91.
doi: 10.1016/j.neurad.2013.10.001
pubmed: 24405685
Koyanagi M, Mosimann PJ, Nordmeyer H, Heddier M, Krause J, Narata AP, Serwi AE, Stracke CP, Chapot R. The transvenous retrograde pressure cooker technique for the curative embolization of high-grade brain arteriovenous malformations. J Neurointerv Surg. 2021;13:637–41.
doi: 10.1136/neurintsurg-2020-016566
pubmed: 32900907
Shi ZS, Loh Y, Gonzalez N, Tateshima S, Feng L, Jahan R, Duckwiler G, Viñuela F. Flow control techniques for Onyx embolization of intracranial dural arteriovenous fistulae. J Neurointerv Surg. 2013;5:311–6.
doi: 10.1136/neurintsurg-2012-010303
pubmed: 22591733
Hou K, Ji T, Guo Y, Xu B, Xu K, Yu J. Current Status of Endovascular Treatment for Dural Arteriovenous Fistulas in the Superior Sagittal Sinus Region: A Systematic Review of the Literature. World Neurosurg. 2019;122:133–43.
doi: 10.1016/j.wneu.2018.10.145
pubmed: 30391606
Taki W, Yonekawa Y, Iwata H, Uno A, Yamashita K, Amemiya H. A new liquid material for embolization of arteriovenous malformations. AJNR Am J Neuroradiol. 1990;11:163–8.
pubmed: 2105599
pmcid: 8332490
Mounayer C, Hammami N, Piotin M, Spelle L, Benndorf G, Kessler I, Moret J. Nidal embolization of brain arteriovenous malformations using Onyx in 94 patients. AJNR Am J Neuroradiol. 2007;28:518–23.
pubmed: 17353327
pmcid: 7977844
Cekirge S, Saatci I, Arat A, Ozcan OE, Ozgen T: Long intranidal Onyx injections in the endovascular treatment of pial brain AVMs: description of a new technique and philosophy aimed at cure. J Neurosurg. 2002;96:173A.
Maimon S, Strauss I, Frolov V, Margalit N, Ram Z. Brain arteriovenous malformation treatment using a combination of Onyx and a new detachable tip microcatheter, SONIC: short-term results. AJNR Am J Neuroradiol. 2010;31:947–54.
doi: 10.3174/ajnr.A1959
pubmed: 20190210
pmcid: 7964165
Debrun GM, Aletich V, Ausman JI, Charbel F, Dujovny M. Embolization of the nidus of brain arteriovenous malformations with n-butyl cyanoacrylate. Neurosurgery. 1997;40:112–20; discussion 120–1.
pubmed: 8971833
Tamatani S, Koike T, Ito Y, Tanaka R. Embolization of Arteriovenous Malformation with Diluted Mixture of NBCA. Interv Neuroradiol. 2000;6(Suppl 1):187–90.
doi: 10.1177/15910199000060S129
pubmed: 20667245
Yu SC, Chan MS, Lam JM, Tam PH, Poon WS. Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure. AJNR Am J Neuroradiol. 2004;25:1139–43.
pubmed: 15313697
pmcid: 7976533
Leonardi M, Barbara C, Simonetti L, Giardino R, Aldini NN, Fini M, Martini L, Masetti L, Joechler M, Roncaroli F. Glubran 2: a new acrylic glue for neuroradiological endovascular use. Experimental study on animals. Interv Neuroradiol. 2002;8:245–50.
doi: 10.1177/159101990200800304
pubmed: 20594482
pmcid: 3572477
Leonardi M, Cenni P, Simonetti L, Bozzao A, Romano A, Bonamini M, Fantozzi LM, Fini G. Glubran 2((r)):a new acrylic glue for neuroradiological endovascular use: a complementary histological study. Interv Neuroradiol. 2003;9:249–54.
doi: 10.1177/159101990300900303
pubmed: 20591250
Liu J, Lv M, Lv X, He H, Liu A, Qian Z, Li Y. Curative glubran 2 embolization of cerebral arteriovenous malformations patient selection and initial results. Interv Neuroradiol. 2014;20:722–8.
doi: 10.15274/INR-2014-10063
pubmed: 25496682
pmcid: 4295244
Izaaryene J, Saeed Kilani M, Rolland PH, Gaubert JY, Jacquier A, Bartoli JM, Vidal V. Preclinical study on an animal model of a new non-adhesive cyanoacrylate (Purefill®) for arterial embolization. Diagn Interv Imaging. 2016;97:1109–16.
doi: 10.1016/j.diii.2016.05.013
pubmed: 27475313
Nico L, Magro E, Ognard J, Fahed R, Salazkin I, Gevry G, Darsaut T, Raymond J, Gentric JC. Comparing N-hexyl cyanoacrylate (Magic Glue) and N-butyl cyanoacrylate (NBCA) for neurovascular embolization using the pressure cooker technique: An experimental study in swine. J Neuroradiol. 2021; https://doi.org/10.1016/j.neurad.2020.12.005 . Epub ahead of print.
doi: 10.1016/j.neurad.2020.12.005
pubmed: 33418056
See AP, Mohammaden MH, Rizko M, Stapleton CJ, Amin-Hanjani S, Charbel FT, Aletich V, Alaraj A. Morbidity and mortality associated with sequential flow reduction embolization technique of cerebral arteriovenous malformations using n-butyl cyanoacrylate. J Neurointerv Surg. 2021;13:237–41.
doi: 10.1136/neurintsurg-2020-016223
pubmed: 33020208
pmcid: 8294207
Lasjaunias PL, Chng SM, Sachet M, Alvarez H, Rodesch G, Garcia-Monaco R. The management of vein of Galen aneurysmal malformations. Neurosurgery. 2006;59(Suppl 3):S184–94; discussion S3-13.
doi: 10.1227/01.NEU.0000237445.39514.16
pubmed: 17053602
Jafar JJ, Davis AJ, Berenstein A, Choi IS, Kupersmith MJ. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg. 1993;78:60–9.
doi: 10.3171/jns.1993.78.1.0060
pubmed: 8416244
Gobin YP, Laurent A, Merienne L, Schlienger M, Aymard A, Houdart E, Casasco A, Lefkopoulos D, George B, Merland JJ. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg. 1996;85:19–28.
doi: 10.3171/jns.1996.85.1.0019
pubmed: 8683274
Blackburn SL, Ashley WW Jr, Rich KM, Simpson JR, Drzymala RE, Ray WZ, Moran CJ, Cross DT 3rd, Chicoine MR, Dacey RG Jr, Derdeyn CP, Zipfel GJ. Combined endovascular embolization and stereotactic radiosurgery in the treatment of large arteriovenous malformations. J Neurosurg. 2011;114:1758–67.
doi: 10.3171/2011.1.JNS10571
pubmed: 21332288
Meisel HJ, Mansmann U, Alvarez H, Rodesch G, Brock M, Lasjaunias P. Effect of partial targeted N-butyl-cyano-acrylate embolization in brain AVM. Acta Neurochir (Wien). 2002;144:879–87; discussion 888.
doi: 10.1007/s00701-002-0978-6
Wu EM, El Ahmadieh TY, McDougall CM, Aoun SG, Mehta N, Neeley OJ, Plitt A, Shen Ban V, Sillero R, White JA, Batjer HH, Welch BG. Embolization of brain arteriovenous malformations with intent to cure: a systematic review. J Neurosurg. 2019;132:388–99.
doi: 10.3171/2018.10.JNS181791
pubmed: 30717053
Loh Y, Duckwiler GR; Onyx Trial Investigators. A prospective, multicenter, randomized trial of the Onyx liquid embolic system and N-butyl cyanoacrylate embolization of cerebral arteriovenous malformations. Clinical article. J Neurosurg. 2010;113:733–41.
doi: 10.3171/2010.3.JNS09370
pubmed: 20433277
Crowley RW, Ducruet AF, Kalani MY, Kim LJ, Albuquerque FC, McDougall CG. Neurological morbidity and mortality associated with the endovascular treatment of cerebral arteriovenous malformations before and during the Onyx era. J Neurosurg. 2015;122:1492–7.
doi: 10.3171/2015.2.JNS131368
pubmed: 25816081
Rodesch G, Hurth M, Alvarez H, David P, Tadie M, Lasjaunias P. Embolization of spinal cord arteriovenous shunts: morphological and clinical follow-up and results--review of 69 consecutive cases. Neurosurgery. 2003;53:40–9; discussion 49–50.
doi: 10.1227/01.neu.0000068701.25600.a1
pubmed: 12823872
Kim DJ, Willinsky RA, Krings T, Agid R, Terbrugge K. Intracranial dural arteriovenous shunts: transarterial glue embolization--experience in 115 consecutive patients. Radiology. 2011;258:554–61.
doi: 10.1148/radiol.10100755
pubmed: 21177391
Guedin P, Gaillard S, Boulin A, Condette-Auliac S, Bourdain F, Guieu S, Dupuy M, Rodesch G. Therapeutic management of intracranial dural arteriovenous shunts with leptomeningeal venous drainage: report of 53 consecutive patients with emphasis on transarterial embolization with acrylic glue. J Neurosurg. 2010;112:603–10.
doi: 10.3171/2009.7.JNS08490
pubmed: 20192669
Miyamoto N, Naito I, Shimizu T, Yoshimoto Y. Efficacy and limitations of transarterial acrylic glue embolization for intracranial dural arteriovenous fistulas. Neurol Med Chir (Tokyo). 2015;55:163–72.
doi: 10.2176/nmc.oa.2014-0223
Murayama Y, Viñuela F, Ulhoa A, Akiba Y, Duckwiler GR, Gobin YP, Vinters HV, Greff RJ. Nonadhesive liquid embolic agent for cerebral arteriovenous malformations: preliminary histopathological studies in swine rete mirabile. Neurosurgery. 1998;43:1164–75.
doi: 10.1097/00006123-199811000-00081
pubmed: 9802860
Chaloupka JC, Viñuela F, Vinters HV, Robert J. Technical feasibility and histopathologic studies of ethylene vinyl copolymer (EVAL) using a swine endovascular embolization model. AJNR Am J Neuroradiol. 1994;15:1107–15.
pubmed: 8073980
pmcid: 8333455
Wang J, Wu HC, Wang WW, Zhao HS, Dao RN, Liu WM, Zhou DZ, Wang HY, DU C. Trigeminal Cardiac Reflex Caused by Onyx Embolization of Intracranial Dural Arteriovenous Fistula. Turk Neurosurg. 2016;26:325–30.
doi: 10.5137/1019-5149.JTN.8008-13.1
pubmed: 27161455
Puri AS, Thiex R, Zarzour H, Rahbar R, Orbach DB. Trigeminocardiac reflex in a child during pre-Onyx DMSO injection for juvenile nasopharyngeal angiofibroma embolization. A case report. Interv Neuroradiol. 2011;17:13–6.
doi: 10.1177/159101991101700103
pubmed: 21561553
pmcid: 3278028
Ozpar R, Nas OF, Hacikurt K, Taskapilioglu MO, Kocaeli H, Hakyemez B. Endovascular treatment of intracranial arteriovenous malformations using detachable-tip microcatheters and Onyx 18®. Diagn Interv Imaging. 2019;100:353–61.
doi: 10.1016/j.diii.2019.01.009
pubmed: 30857993
Flores BC, See AP, Weiner GM, Jankowitz BT, Ducruet AF, Albuquerque FC. Use of the Apollo detachable-tip microcatheter for endovascular embolization of arteriovenous malformations and arteriovenous fistulas. J Neurosurg. 2018;130:963–71.
doi: 10.3171/2017.9.JNS17397
pubmed: 29570006
Herial NA, Khan AA, Sherr GT, Qureshi MH, Suri MF, Qureshi AI. Detachable-Tip Microcatheters for Liquid Embolization of Brain Arteriovenous Malformations and Fistulas: A United States Single-Center Experience. Neurosurgery. 2015;11 Suppl 3:404–11; discussion 411.
doi: 10.1227/NEU.0000000000000839
pubmed: 26083156
Herial NA, Khan AA, Suri MF, Sherr GT, Qureshi AI. Liquid embolization of brain arteriovenous malformation using novel detachable tip micro catheter: a technical report. J Vasc Interv Neurol. 2014;7:64–8.
pubmed: 25566344
pmcid: 4280868
Weber W, Kis B, Siekmann R, Kuehne D. Endovascular treatment of intracranial arteriovenous malformations with onyx: technical aspects. AJNR Am J Neuroradiol. 2007;28:371–7.
pubmed: 17297015
pmcid: 7977391
Jagadeesan BD, Grigoryan M, Hassan AE, Grande AW, Tummala RP. Endovascular balloon-assisted embolization of intracranial and cervical arteriovenous malformations using dual-lumen coaxial balloon microcatheters and Onyx: initial experience. Neurosurgery. 2013;73(2 Suppl Operative):ons238–43; discussion ons243.
doi: 10.1227/NEU.0000000000000186
pubmed: 24077579
Lencioni R, de Baere T, Burrel M, Caridi JG, Lammer J, Malagari K, Martin RC, O’Grady E, Real MI, Vogl TJ, Watkinson A, Geschwind JF. Transcatheter treatment of hepatocellular carcinoma with Doxorubicin-loaded DC Bead (DEBDOX): technical recommendations. Cardiovasc Intervent Radiol. 2012;35:980–5.
doi: 10.1007/s00270-011-0287-7
pubmed: 22009576
Spiotta AM, James RF, Lowe SR, Vargas J, Turk AS, Chaudry MI, Bhalla T, Janjua RM, Delaney JJ, Quintero-Wolfe S, Turner RD. Balloon-augmented Onyx embolization of cerebral arteriovenous malformations using a dual-lumen balloon: a multicenter experience. J Neurointerv Surg. 2015;7:721–7.
doi: 10.1136/neurintsurg-2014-011285
pubmed: 25118193
Vollherbst DF, Chapot R, Wallocha M, Saatci I, Cekirge S, Rouchaud A, Mounayer C, Kocer N, Kizilkilic O, Sourour NA, Shotar E, Psychogios MN, Brehm A, Bendszus M, Möhlenbruch MA. First clinical multicenter experience with the new Scepter Mini microballoon catheter. J Neurointerv Surg. 2021;13:261–6.
doi: 10.1136/neurintsurg-2020-016115
pubmed: 32546639
Vollherbst DF, Otto R, Do T, Kauczor HU, Bendszus M, Sommer CM, Möhlenbruch MA. Imaging artifacts of Onyx and PHIL on conventional CT, cone-beam CT and MRI in an animal model. Interv Neuroradiol. 2018;24:693–701.
doi: 10.1177/1591019918782692
pubmed: 29973083
pmcid: 6259339
Pop R, Mertz L, Ilyes A, Mihoc D, Richter JS, Manisor M, Kremer S, Beaujeux R. Beam hardening artifacts of liquid embolic agents: comparison between Squid and Onyx. J Neurointerv Surg. 2019;11:706–9.
doi: 10.1136/neurintsurg-2018-014542
pubmed: 30567844
Schmitt N, Floca RO, Paech D, El Shafie RA, Seker F, Bendszus M, Möhlenbruch MA, Vollherbst DF. Imaging Artifacts of Liquid Embolic Agents on Conventional CT in an Experimental in Vitro Model. AJNR Am J Neuroradiol. 2021;42:126–31.
doi: 10.3174/ajnr.A6867
pubmed: 33214178
pmcid: 7814783
Schmitt N, Floca RO, Paech D, El Shafie RA, Neuberger U, Bendszus M, Möhlenbruch MA, Vollherbst DF. Imaging Artifacts of Nonadhesive Liquid Embolic Agents in Conventional and Cone-beam CT in a Novel in Vitro AVM Model. Clin Neuroradiol. 2021; https://doi.org/10.1007/s00062-021-01013-5 . Epub ahead of print.
doi: 10.1007/s00062-021-01013-5
pubmed: 34643742
pmcid: 8648665
Lv X, Wu Z, Li Y, Yang X, Jiang C. Hemorrhage risk after partial endovascular NBCA and ONYX embolization for brain arteriovenous malformation. Neurol Res. 2012;34:552–6.
doi: 10.1179/1743132812Y.0000000044
pubmed: 22663933
Friedlander RM. Clinical practice. Arteriovenous malformations of the brain. N Engl J Med. 2007;356:2704–12.
doi: 10.1056/NEJMcp067192
pubmed: 17596605
Pereira GC, Traughber M, Muzic RF Jr. The role of imaging in radiation therapy planning: past, present, and future. Biomed Res Int. 2014;2014:231090.
doi: 10.1155/2014/231090
pubmed: 24812609
pmcid: 4000658
Shtraus N, Schifter D, Corn BW, Maimon S, Alani S, Frolov V, Matceyevsky D, Kanner AA. Radiosurgical treatment planning of AVM following embolization with Onyx: possible dosage error in treatment planning can be averted. J Neurooncol. 2010;98:271–6.
doi: 10.1007/s11060-010-0177-x
pubmed: 20383557
Roberts DA, Balter JM, Chaudhary N, Gemmete JJ, Pandey AS. Dosimetric measurements of Onyx embolization material for stereotactic radiosurgery. Med Phys. 2012;39:6672–81.
doi: 10.1118/1.4757918
pubmed: 23127061
Giantsoudi D, De Man B, Verburg J, Trofimov A, Jin Y, Wang G, Gjesteby L, Paganetti H. Metal artifacts in computed tomography for radiation therapy planning: dosimetric effects and impact of metal artifact reduction. Phys Med Biol. 2017;62:R49–80.
doi: 10.1088/1361-6560/aa5293
pubmed: 28323641
Pierot L, Januel AC, Herbreteau D, Barreau X, Drouineau J, Berge J, Sourour N, Cognard C. Endovascular treatment of brain arteriovenous malformations using onyx: preliminary results of a prospective multicenter study. Interv Neuroradiol. 2005;11(Suppl 1):159–64.
doi: 10.1177/15910199050110S119
pubmed: 20584470
pmcid: 3404757
Panagiotopoulos V, Gizewski E, Asgari S, Regel J, Forsting M, Wanke I. Embolization of intracranial arteriovenous malformations with ethylene-vinyl alcohol copolymer (Onyx). AJNR Am J Neuroradiol. 2009;30:99–106.
doi: 10.3174/ajnr.A1314
pubmed: 18842759
pmcid: 7051737
Saatci I, Geyik S, Yavuz K, Cekirge HS. Endovascular treatment of brain arteriovenous malformations with prolonged intranidal Onyx injection technique: long-term results in 350 consecutive patients with completed endovascular treatment course. J Neurosurg. 2011;115:78–88.
doi: 10.3171/2011.2.JNS09830
pubmed: 21476804
Katsaridis V, Papagiannaki C, Aimar E. Curative embolization of cerebral arteriovenous malformations (AVMs) with Onyx in 101 patients. Neuroradiology. 2008;50:589–97.
doi: 10.1007/s00234-008-0382-x
pubmed: 18408923
Vollherbst DF, Herweh C, Schönenberger S, Seker F, Nagel S, Ringleb PA, Bendszus M, Möhlenbruch MA. The Influence of Angioarchitectural Features on the Success of Endovascular Embolization of Cranial Dural Arteriovenous Fistulas with Onyx. AJNR Am J Neuroradiol. 2019;40:2130–6.
doi: 10.3174/ajnr.A6326
pubmed: 31753837
pmcid: 6975346
Mason JR, Dodge C, Benndorf G. Quantification of tantalum sedimentation rates in liquid embolic agents. Interv Neuroradiol. 2018;24:574–9.
doi: 10.1177/1591019918773443
pubmed: 29781371
pmcid: 6116121
Vollherbst DF, Otto R, Hantz M, Ulfert C, Kauczor HU, Bendszus M, Sommer CM, Möhlenbruch MA. Investigation of a New Version of the Liquid Embolic Agent PHIL with Extra-Low-Viscosity in an Endovascular Embolization Model. AJNR Am J Neuroradiol. 2018;39:1696–702.
doi: 10.3174/ajnr.A5750
pubmed: 30093480
pmcid: 7655283
Samaniego EA, Derdeyn CP, Hayakawa M, Hasan D, Ortega-Gutierrez S. In vivo evaluation of the new PHIL low viscosity in a swine rete mirabile model. Interv Neuroradiol. 2018;24:706–12.
doi: 10.1177/1591019918784915
pubmed: 29973081
pmcid: 6259347
Lozupone E, Bracco S, Trombatore P, Milonia L, D’Argento F, Alexandre A, Valente I, Semeraro V, Cioni S, Pedicelli A. Endovascular treatment of cerebral dural arteriovenous fistulas with SQUID 12. Interv Neuroradiol. 2020;26:651–7.
doi: 10.1177/1591019920954095
pubmed: 32842833
pmcid: 7645197
Akmangit I, Daglioglu E, Kaya T, Alagoz F, Sahinoglu M, Peker A, Derakshani S, Dede D, Belen D, Arat A. Preliminary experience with squid: a new liquid embolizing agent for AVM, AV fistulas and tumors. Turk Neurosurg. 2014;24:565–70.
doi: 10.5137/1019-5149.JTN.11179-14.0
pubmed: 25050683
Vollherbst DF, Otto R, von Deimling A, Pfaff J, Ulfert C, Kauczor HU, Bendszus M, Sommer CM, Möhlenbruch MA. Evaluation of a novel liquid embolic agent (precipitating hydrophobic injectable liquid (PHIL)) in an animal endovascular embolization model. J Neurointerv Surg. 2018;10:268–74.
doi: 10.1136/neurintsurg-2017-013144
pubmed: 28689184
Vollherbst DF, Sommer CM, Ulfert C, Pfaff J, Bendszus M, Möhlenbruch MA. Liquid Embolic Agents for Endovascular Embolization: Evaluation of an Established (Onyx) and a Novel (PHIL) Embolic Agent in an In Vitro AVM Model. AJNR Am J Neuroradiol. 2017;38:1377–82.
doi: 10.3174/ajnr.A5203
pubmed: 28522669
pmcid: 7959908
Sirakov SS, Sirakov A, Minkin K, Hristov H, Ninov K, Penkov M, Karakostov V, Orlov K, Gorbatykh A, Kislitsin D, Raychev R. Initial experience with precipitating hydrophobic injectable liquid in cerebral arteriovenous malformations. Interv Neuroradiol. 2019;25:58–65.
doi: 10.1177/1591019918798808
pubmed: 30223686
Samaniego EA, Kalousek V, Abdo G, Ortega-Gutierrez S. Preliminary experience with Precipitating Hydrophobic Injectable Liquid (PHIL) in treating cerebral AVMs. J Neurointerv Surg. 2016;8:1253–5.
doi: 10.1136/neurintsurg-2015-012210
pubmed: 26819446
Koçer N, Hanımoğlu H, Batur Ş, Kandemirli SG, Kızılkılıç O, Sanus Z, Öz B, Işlak C, Kaynar MY. Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations. Diagn Interv Radiol. 2016;22:184–9.
doi: 10.5152/dir.2015.15283
pubmed: 26782157
pmcid: 4790072
Varadharajan S, Ramalingaiah AH, Saini J, Gupta AK, Devi BI, Acharya UV. Precipitating hydrophobic injectable liquid embolization of intracranial vascular shunts: initial experience and technical note. J Neurosurg. 2018;129:1217–22.
doi: 10.3171/2017.6.JNS16447
pubmed: 29192863
Kortman HG, Boukrab I, Bloemsma G, Peluso JP, Sluzewski M, van der Pol B, Beute GN, Majoie CB, van Rooij WJ. Tentorial Dural Arteriovenous Fistulas: A Single-Center Cohort of 12 Patients. J Cerebrovasc Endovasc Neurosurg. 2017;19:284–90.
doi: 10.7461/jcen.2017.19.4.284
pubmed: 29387629
pmcid: 5788836
Lamin S, Chew HS, Chavda S, Thomas A, Piano M, Quilici L, Pero G, Holtmannspolter M, Cronqvist ME, Casasco A, Guimaraens L, Paul L, Gil Garcia A, Aleu A, Chapot R. Embolization of Intracranial Dural Arteriovenous Fistulas Using PHIL Liquid Embolic Agent in 26 Patients: A Multicenter Study. AJNR Am J Neuroradiol. 2017;38:127–31.
doi: 10.3174/ajnr.A5037
pubmed: 27932510
pmcid: 7963645
Leyon JJ, Chavda S, Thomas A, Lamin S. Preliminary experience with the liquid embolic material agent PHIL (Precipitating Hydrophobic Injectable Liquid) in treating cranial and spinal dural arteriovenous fistulas: technical note. J Neurointerv Surg. 2016;8:596–602.
doi: 10.1136/neurintsurg-2015-011684
pubmed: 25994938
Lv X, Zhang Y, Wang J. Systematic Review of Transcatheter Arterial Embolization of AVM: Indications, Bleeding Complications, Cure Rate, and Long-Term Bleeding Risk. Neurol India. 2020;68:1285–92.
doi: 10.4103/0028-3886.304101
pubmed: 33342854
Jahan R, Murayama Y, Gobin YP, Duckwiler GR, Vinters HV, Viñuela F. Embolization of arteriovenous malformations with Onyx: clinicopathological experience in 23 patients. Neurosurgery. 2001;48:984–95; discussion 995–7.
doi: 10.1097/00006123-200105000-00003
pubmed: 11334300
Duffner F, Ritz R, Bornemann A, Freudenstein D, Wiendl H, Siekmann R. Combined therapy of cerebral arteriovenous malformations: histological differences between a non-adhesive liquid embolic agent and n-butyl 2-cyanoacrylate (NBCA). Clin Neuropathol. 2002;21:13–7.
pubmed: 11846039
Vinters HV, Galil KA, Lundie MJ, Kaufmann JC. The histotoxicity of cyanoacrylates. A selective review. Neuroradiology. 1985;27:279–91.
doi: 10.1007/BF00339559
pubmed: 3900798
Bakar B, Oruckaptan HH, Hazer BD, Saatci I, Atilla P, Kilic K, Muftuoglu SF. Evaluation of the toxicity of onyx compared with n-butyl 2-cyanoacrylate in the subarachnoid space of a rabbit model: an experimental research. Neuroradiology. 2010;52:125–34.
doi: 10.1007/s00234-009-0594-8
pubmed: 19756562
Schirmer CM, Zerris V, Malek AM. Electrocautery-induced ignition of spark showers and self-sustained combustion of onyx ethylene-vinyl alcohol copolymer. Neurosurgery. 2006;59(4 Suppl 2):ONS413-8.
doi: 10.1227/01.NEU.0000240683.15391.99
pubmed: 17041511