Safety and Effectiveness of Ethylene Vinyl Alcohol Copolymer Embolization of Peripheral High-Flow Arteriovenous Malformations: Results of a Prospective Study |
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Affiliation: | 1. University Clinic and Policlinic of Radiology, Universitätsklinikum Halle (Saale), Halle (Saale), Germany;2. Department of Angiology, Universitätsklinikum Halle (Saale), Halle (Saale), Germany;3. Department of Visceral, Vascular and Endocrine Surgery, Universitätsklinikum Halle (Saale), Halle (Saale), Germany;4. Department of Radiology, University Hospital Ludwig-Maximilians-Universität, Munich, Germany;5. Department for Diagnostic and Interventional Radiology and Neuroradiology, Universitätsklinikum Augsburg, Augsburg, Germany |
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Abstract: | PurposeTo prospectively evaluate the efficacy and safety of a new ethylene vinyl alcohol (EVOH) copolymer–based embolic agent in the treatment of symptomatic peripheral arteriovenous malformations (AVMs).Materials and MethodsThis prospective single-center study evaluated EVOH embolization with 3 different formulations of EVOH (Squid Peri 12 cP, 18 cP, and 34 cP; BALT Germany GmbH, Düsseldorf, Germany) in patients with symptomatic AVMs. Between April 2018 and October 2019, 36 embolization procedures in 21 patients (3 males and 18 females; mean age, 34.7 years) were performed (inclusion criteria: symptomatic peripheral AVM, ≥14 years of age, and elective embolization). Symptoms, technical aspects (transarterial, transvenous, or percutaneous approach; plug or balloon occlusion), clinical and technical success (defined as the improvement of symptoms and complete angiographic eradication of the AVM nidus), adverse events, and short-term outcomes were assessed.ResultsThe mean volume of the embolic agent used per session was 3.4 mL of EVOH 34 cP (standard deviation [SD], ± 5.4), 6.2 mL ± 8.1 of EVOH 18 cP, and 4.6 mL ± 10.1 of EVOH 12 cP. Angiographic success was achieved in 18 patients (85.7%). The mean follow-up was 190 days (range, 90–538 days; median, 182 days). In the follow-up assessment, findings of magnetic resonance imaging showed that 19 patients (90.5%) had a persistent state of devascularization compared with postinterventional angiography. Amelioration or complete elimination of pain was achieved in 90.0% of the patients. One patient experienced a major adverse event; minor adverse events developed in 2 patients.ConclusionsIn this study, EVOH appeared to be a safe and effective embolic agent in peripheral AVMs and had a low rate of adverse events in a limited number of patients. |
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Keywords: | AVM" },{" #name" :" keyword" ," $" :{" id" :" kwrd0015" }," $$" :[{" #name" :" text" ," _" :" arteriovenous malformation DMSO" },{" #name" :" keyword" ," $" :{" id" :" kwrd0025" }," $$" :[{" #name" :" text" ," _" :" dimethyl sulfoxide EVOH" },{" #name" :" keyword" ," $" :{" id" :" kwrd0035" }," $$" :[{" #name" :" text" ," _" :" ethylene vinyl alcohol NBCA" },{" #name" :" keyword" ," $" :{" id" :" kwrd0045" }," $$" :[{" #name" :" text" ," $$" :[{" #name" :" italic" ," _" :" n" },{" #name" :" __text__" ," _" :" -butyl cyanoacrylate SD" },{" #name" :" keyword" ," $" :{" id" :" kwrd0055" }," $$" :[{" #name" :" text" ," _" :" standard deviation |
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