Novel use of precipitating hydrophobic injectable liquid (PHIL) in pre-operative angioembolisation of a large posterior auricular arteriovenous malformation

Large arteriovenous malformations are often managed via endovascular embolisation followed by surgical resection. We describe the use of a new liquid embolic agent (LEA) - precipitating hydrophobic injectable liquid (PHIL) and its advantages over existing LEAs. A 60-year-old male presented with a pr...

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Bibliographic Details
Published in:American journal of otolaryngology 2023-03, Vol.44 (2), p.103786, Article 103786
Main Authors: Chu, Clarisse, Tan, Toh Hui Leonard, Ng, Keng Sin, Tan, Chien Sheng, Lee, Tee Sin, Yuen, Heng Wai, Lee, Wickly, Huang, Xin Yong
Format: Article
Language:English
Subjects:
Arteriovenous malformation
Embolization, therapeutic
Embolization, Therapeutic - methods
Endovascular Procedures - methods
Ethylene-vinyl alcohol copolymer
Humans
Intracranial Arteriovenous Malformations - therapy
Male
Middle Aged
Otolaryngology
Polyvinyls
Radiology, interventional
Treatment Outcome
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Summary:Large arteriovenous malformations are often managed via endovascular embolisation followed by surgical resection. We describe the use of a new liquid embolic agent (LEA) - precipitating hydrophobic injectable liquid (PHIL) and its advantages over existing LEAs. A 60-year-old male presented with a progressively enlarging right post-auricular arteriovenous malformation. He underwent successive angioembolisation with PHIL and subsequent surgical resection on post-embolisation day 1. To our knowledge, this is the first reported case of PHIL being used in pre-operative embolization of a large extra-cranial head and neck AVM. Its excellent penetration into small calibre vessels, decreased glare artefact on imaging and decreased skin pigmentation render it a compelling alternative to existing LEAs.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2022.103786