title: Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations.
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.
authors.affiliation: Division of Neuroradiology, the Department of Radiology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey. nkocer@istanbul.edu.tr.
authors.forename: Naci
authors.initials: N
authors.lastname: Koçer
authors.forename: Hakan
authors.initials: H
authors.lastname: Hanımoğlu
authors.forename: Şebnem
authors.initials: Ş
authors.lastname: Batur
authors.forename: Sedat Giray
authors.initials: SG
authors.lastname: Kandemirli
authors.forename: Osman
authors.initials: O
authors.lastname: Kızılkılıç
authors.forename: Zihni
authors.initials: Z
authors.lastname: Sanus
authors.forename: Büge
authors.initials: B
authors.lastname: Öz
authors.forename: Civan
authors.initials: C
authors.lastname: Işlak
authors.forename: Mehmet Yaşar
authors.initials: MY
authors.lastname: Kaynar
mesh_terms: D000328:Adult; D002675:Child, Preschool; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D004338:Drug Combinations; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D011145:Polyvinyls / Q000008:administration & dosage; D013635:Tantalum / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D004338:Drug Combinations; C558446:Onyx 18; C000598428:Onyx 34; D011145:Polyvinyls; D013635:Tantalum; D004121:Dimethyl Sulfoxide