title: Dual-lumen balloon catheters may improve liquid embolization of vascular malformations: an experimental study in Swine.
abstract: OBJECTIVE
  Liquid embolic agents are increasingly used to treat vascular malformations. We sought to assess embolization with these agents by using a dual-lumen balloon catheter in an experimental setting.
  
  
  METHODS
  Eighteen injections of liquid embolic agents were performed in the rete mirabile of swine. We used 3 methods to control liquid embolic agent reflux: 1) dual-lumen balloon-catheter (group A, n = 8); 2) injection of liquid embolic agent after proximal n-BCA plug formation through a second microcatheter (group B, n = 4); and 3) standard liquid embolic agent injection (group C, controls, n = 6). The following outcomes were graded by using ordinal scales by angiography, macrophotography, and radiography of retia after euthanasia: 1) angiographic and pathologic extent of liquid embolic agent embolization of the rete, 2) reflux of liquid embolic agents in the parent artery, and 3) density of liquid embolic agents in the proximal rete. Technical complications were also recorded. A successful injection was defined as an embolization that reached the contralateral rete without reflux into proximal external branches. Exact logistic regression analyses were performed to compare groups.
  
  
  RESULTS
  There were significant differences among groups for reflux (P = .029) and liquid embolic agent density in the proximal rete (P = .014), while extension to the contralateral rete did not reach statistical significance (P = .07). Injections differed among groups (P = .004), with dual-lumen balloon-catheter injections more frequently successful compared with control injections (P = .019).
  
  
  CONCLUSIONS
  Dual-lumen balloon catheters allowed better liquid embolic agent injections than standard injections.
authors.affiliation: From the Department of Radiology (J.C.G., J.R., A.B.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Equipe d'Accueil 3878 - Groupe d'Etude de la Thrombose en Bretagne Occidentale (J.C.G.), Université de Bretagne Occidentale, Brest, France.
authors.forename: J C
authors.initials: JC
authors.lastname: Gentric
authors.affiliation: From the Department of Radiology (J.C.G., J.R., A.B.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Laboratory of Interventional Neuroradiology (J.R., I.S., G.G.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital Research Centre, Montreal, Quebec, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Raymond
authors.affiliation: From the Department of Radiology (J.C.G., J.R., A.B.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada.
authors.forename: A
authors.initials: A
authors.lastname: Batista
authors.affiliation: Laboratory of Interventional Neuroradiology (J.R., I.S., G.G.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital Research Centre, Montreal, Quebec, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Salazkin
authors.affiliation: Laboratory of Interventional Neuroradiology (J.R., I.S., G.G.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital Research Centre, Montreal, Quebec, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Gevry
authors.affiliation: Division of Neurosurgery (T.E.D.), Department of Surgery, University of Alberta Hospital, Mackenzie Health Sciences Centre, Edmonton, Alberta, Canada tdarsaut@ualberta.ca.
authors.forename: T E
authors.initials: TE
authors.lastname: Darsaut
mesh_terms: D000818:Animals; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D007267:Injections; D013552:Swine; D054079:Vascular Malformations / Q000628:therapy*