Interventional Radiology - Technical Note

Preliminary experience with precipitating hydrophobic injectable liquid in brain arteriovenous malformations

10.5152/dir.2015.15283

  • Naci Koçer
  • Hakan Hanımoğlu
  • Şebnem Batur
  • Sedat Giray Kandemirli
  • Osman Kızılkılıç
  • Zihni Sanus
  • Büge Öz
  • Civan Işlak
  • Mehmet Yaşar Kaynar

Received Date: 27.06.2015 Accepted Date: 03.08.2015 Diagn Interv Radiol 2016;22(2):184-189

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.