PT  - JOURNAL ARTICLE
AU  - S. Lamin
AU  - H.S. Chew
AU  - S. Chavda
AU  - A. Thomas
AU  - M. Piano
AU  - L. Quilici
AU  - G. Pero
AU  - M. Holtmannspolter
AU  - M.E. Cronqvist
AU  - A. Casasco
AU  - L. Guimaraens
AU  - L. Paul
AU  - A. Gil Garcia
AU  - A. Aleu
AU  - R. Chapot
TI  - Embolization of Intracranial Dural Arteriovenous Fistulas Using PHIL Liquid Embolic Agent in 26 Patients: A Multicenter Study
AID  - 10.3174/ajnr.A5037
DP  - 2017 Jan 01
TA  - American Journal of Neuroradiology
PG  - 127--131
VI  - 38
IP  - 1
4099  - http://www.ajnr.org/content/38/1/127.short
4100  - http://www.ajnr.org/content/38/1/127.full
SO  - Am. J. Neuroradiol.2017 Jan 01; 38
AB  - BACKGROUND AND PURPOSE: The introduction of liquid embolic agents has revolutionized endovascular approach to cranial vascular malformations. The aim of the study was to retrospectively assess the efficacy and safety of Precipitating Hydrophobic Injectable Liquid (PHIL), a new nonadhesive liquid embolic agent, in the treatment of patients with cranial dural arteriovenous fistulas. The primary end point was the rate of complete occlusion of dural arteriovenous fistulas. Secondary end points included the incidence of adverse events and clinical status at 3-month follow-up.MATERIALS AND METHODS: This was a retrospective multicenter study. Twenty-six consecutive patients with dural arteriovenous fistulas (de novo or previously treated) treated by injection of PHIL only or with PHIL in combination with other embolization products (such as Onyx or detachable coils) were included in the study. Recruitment started in August 2014 and ended in September 2015.RESULTS: Twenty-two (85%) patients were treated with PHIL only, with 3 patients treated with both PHIL and Onyx, and 1, with both PHIL and coils. Immediate complete angiographic occlusion was achieved in 20 (77%) patients. Of the 6 patients with residual fistulas, 3 were retreated with PHIL and 1 achieved angiographic cure. An adverse event was seen in 1 patient who developed worsening of preexisting ataxia due to acute thrombosis of the draining vein.CONCLUSIONS: PHIL appears to be safe and effective for endovascular treatment of cranial dural arteriovenous fistulas. Short-term angiographic and clinical results are comparable with those of Onyx, with the added advantage of easier preparation and improved homogeneous cast visualization. The use of iodine as a radio-opacifier also produces considerably less artifacts on CT compared with tantalum-based embolic materials.DAVFdural arteriovenous fistulaDMSOdimethyl-sulfoxidePHILPrecipitating Hydrophobic Injectable Liquid