Purpose: This paper aims to report on the preliminary experience of a single center in the embolization of peripheral AVMs with Precipitating Hydrophobic Injectable Liquid (PHIL®), focusing on technical aspects and short term clinical outcomes.
Material and Methods: Three males and five females were included in this study, mean age 43 years. For six of them it was the first embolization treatment; only two patients had been previously treated with Onyx® embolization. No other embolic agents were injected during the same procedure. Lesions were localized in: small bowell (1), colon (1), head (3), forefoot (1) and uterus (2); all were symptomatic After 30 days clinical follow-up, a contrast-enhanced CT or MR was acquired at three monthes from intervention to detect eventual lesion residual.
Results: All embolization procedures have been accomplished as planned, with a transarterial approach only. After a single embolization procedure, complete technical success was obtained in 50% while clinical improvement without additional therapies was appreciable in all patients except one (clinical success: 87.5%). No technical failure occurred; in two cases, a small amount of Phil proximally refluxed in non-target vessels without clinical effects. No tattoing effects of superfical lesions neither artifacts at CT and conebeam CT controls were evident.
Conclusions: Phil® seems to be a safe and effective liquid embolic agent for the treatment of peripheral AVMs; compared to Onyx®, it presents the advantages of reduced artifacts at postprocedural CT scan and no need for shaking time preparation but it is more expensive due to lower volume of product for each package.
.jpg "Francesco Giurazza, MD, PhD, EBIR photo")