Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

Diagn Interv Radiol. Mar-Apr 2016;22(2):184-9. doi: 10.5152/dir.2015.15283.

Abstract

Advancement in microcatheter design and emergence of new embolic agents offer better results in endovascular treatment of brain arteriovenous malformations (AVMs). Precipitating hydrophobic injectable liquid (PHIL) (Microvention) is a newly introduced dimethyl sulfoxide-based embolic agent for endovascular use. Herein, we present three patients who underwent endovascular treatment of brain AVMs with PHIL, followed by surgical resection. Endovascular features and same-day surgical handling of the new embolic agent PHIL are presented along with histopathologic changes in the acute stage in brain AVMs are presented, and its major differences from Onyx. In our series, PHIL had moderate inflammatory reaction in the acute stage without any associated angionecrosis that is different than Onyx which cause mild inflammatory reaction with angionecrosis. Smallest vessel containing PHIL was 2.9 μm compared to 5 μm with Onyx, which suggests better penetration.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Child, Preschool
  • Dimethyl Sulfoxide / administration & dosage*
  • Drug Combinations
  • Embolization, Therapeutic / methods*
  • Female
  • Humans
  • Intracranial Arteriovenous Malformations / diagnostic imaging*
  • Intracranial Arteriovenous Malformations / therapy*
  • Male
  • Polyvinyls / administration & dosage
  • Tantalum / administration & dosage
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome
  • Young Adult

Substances

  • Drug Combinations
  • Onyx 18
  • Onyx 34
  • Polyvinyls
  • Tantalum
  • Dimethyl Sulfoxide