title: Treatment of Type II Endoleaks with a Novel Agent: Precipitating Hydrophobic Injectable Liquid (PHIL).
abstract: OBJECTIVE
  Endovascular aortic aneurysm repair has become the principle technique used to treat abdominal aortic aneurysms. However, its long-term success is limited by complications, including type II endoleaks from lumbar arteries and the inferior mesenteric artery. Treatment of these endoleaks can be difficult. The most commonly performed procedure is embolisation via mesenteric or iliolumbar vessels. Embolic agents currently used include coils, glue and Onyx, all of which have their limitations. Our aim was to assess a novel embolic agent precipitating hydrophobic injectable liquid (PHIL) this is currently used in the treatment by neuro-interventionists in the treatment of cerebral arterio-venous malformations.
  
  
  METHODS
  Here we describe three patients successfully treated with PHIL.
  
  
  RESULTS
  All three patients had type II endoleaks which were successfully embolised. PHIL displayed favourable embolic characteristics with good distal penetration, rapid injection speed and a lack of glare artefact on follow-up CT.
  
  
  CONCLUSIONS
  PHIL is a promising novel embolic agent in the treatment of type II endoleaks, our initial experience has been positive but larger series will be required to evaluate this further.
authors.affiliation: Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, England, UK. amirhelmy83@gmail.com.
authors.forename: Amir
authors.identifier: http://orcid.org/0000-0002-8113-6043
authors.initials: A
authors.lastname: Helmy
authors.affiliation: Addenbrookes Hospital, Hills Road, Cambridge, CB2 0QQ, England, UK.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Shaida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057867:Endoleak / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer
keywords: Endovascular aortic aneurysm repair (EVAR); Precipitating hydrophobic injectable liquid (PHIL); Type II endoleak