Safety and Effectiveness of Ethylene Vinyl Alcohol Copolymer Embolization of Peripheral High-Flow Arteriovenous Malformations: Results of a Prospective Study

Brill, Richard M.; Guntau, Moritz; Wildgruber, Moritz; Brill, Eva; Stangl, Franz; Taute, Bettina-Maria; Ukkat, Jörg; Goldann, Constantin und Wohlgemuth, Walter Alexander (2021): Safety and Effectiveness of Ethylene Vinyl Alcohol Copolymer Embolization of Peripheral High-Flow Arteriovenous Malformations: Results of a Prospective Study. In: Journal of Vascular and Interventional Radiology, Bd. 32, Nr. 12: 1644-

Abstract

Purpose: To 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 Methods: This 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, Dusseldorf, 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 emholization). 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. Results: The 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. Conclusions: In this study. EVOH appeared to he a safe and effective embolic agent in peripheral AVMs and had a low rate of adverse events in a limited number of patients.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1051-0443
• Sprache: Englisch