Embolization of peripheral arteriovenous malformations and fistulas with precipitating hydrophobic injectable liquid (PH
- PDF / 1,334,156 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 10 Downloads / 184 Views
VASCULAR AND INTERVENTIONAL RADIOLOGY
Embolization of peripheral arteriovenous malformations and fistulas with precipitating hydrophobic injectable liquid (PHIL®) Francesco Giurazza1 · Fabio Corvino1 · Mattia Silvestre1 · Gianluca Cangiano1 · Giuseppe De Magistris1 · Errico Cavaglià1 · Francesco Amodio1 · Raffaella Niola1 Received: 28 June 2019 / Accepted: 27 August 2020 © Italian Society of Medical Radiology 2020
Abstract Purpose This paper reports on the preliminary experience of a single center in the embolization of peripheral AVMs and fistulas with precipitating hydrophobic injectable liquid ( PHIL®), focusing on technical aspects and short-term clinical outcomes. Materials and methods Seven males and five females were included in this study, mean age 42.16 years. For ten of them, it was the first embolization treatment; two had been previously treated with O nyx® embolization. P HIL® was injected with a transarterial approach without other embolics during the same procedure. Lesions were localized in small bowel (1), colon (1), head face (5), forefoot (1), uterus (1) and thorax (3); all were symptomatic. After 30-day clinical follow-up, a contrastenhanced CT or MR was acquired at 3 months from intervention to detect eventual lesion residual. Results After a single embolization procedure, complete technical success was obtained in 50%, while clinical improvement without additional therapies was appreciable in all patients. No technical failure occurred; in two cases, a small amount of PHIL® proximally refluxed in nontarget vessels without clinical effects. No tattooing effects of superficial lesions neither artifacts at CT and cone-beam CT controls were evident. Conclusions PHIL® seems to be a safe and effective liquid embolic agent for the treatment of peripheral AVMs and fistulas; although a direct comparison between PHIL and Onyx was not performed, PHIL might present the advantages of reduced artifacts at postprocedural CT scan and no need for shaking time preparation, but it is more expensive due to lower volume of product for each package and slightly less radiopaque at fluoroscopy. Keywords Embolization · Arteriovenous malformation · Fistula · Peripheral · PHIL®
Introduction Arteriovenous malformations (AVMs) are complex vascular structures schematically composed of feeding arteries, a network of pathologic vessels (nidus) and draining veins; according to ISSVA 2018 classification, these are categorized as congenital simple high-flow vascular malformations [1]. On the other hand, fistulas are characterized by an anomalous direct communication between artery and vein, without an interposing nidus. They can be congenital or
* Francesco Giurazza [email protected] 1
Vascular and Interventional Radiology Department, Cardarelli Hospital, Via Antonio Cardarelli 9, 80131 Naples, Italy
acquired; in this latter case, the origin is usually secondary to trauma or inflammation [1]. These lesions are rare and can occur anywhere in the body; according to the localization, they are consi
Data Loading...
