Single institutional experience of peripheral applications of a liquid embolic agent: Ethylene Vinyl Alcohol Copolymer

Abhijit L Salaskar,Andrew Akman,Daniel Scher,Faezeh Razjouyan,Rishi R Sood,Shawn N Sarin,Anthony C Venbrux,Alexander L Cho

doi:10.1186/s42155-020-00117-2

Abhijit L Salaskar, Andrew Akman + Show 6 more

Open Access

https://doi.org/10.1186/s42155-020-00117-2

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Journal: CVIR Endovascular	Publication Date: Aug 2, 2020
Citations: 4	License type: open-access

Affiliation: George Washington University Hospital

Abstract

ObjectiveTo evaluate the safety and efficacy of ethylene vinyl alcohol (EVOH) copolymer for the treatment of a variety of peripheral vascular pathologies.ResultsBetween October 2010 and October 2017, 43 patients who underwent total 54 EVOH embolization procedures for the treatment of peripheral vascular pathologies were included. The cases which involved the use of EVOH for the treatment of nonvascular, neurologic, ophthalmologic, otolaryngologic or head-neck pathologies were excluded. The demographic data, technical and clinical success rates, and procedure-related details and complications were obtained. The most common indications for EVOH embolization were type II endoleaks (n = 18) and peripheral arteriovenous malformations (n = 14). The majority of cases (62.5%) used EVOH without any adjunct embolic material. The results of this study showed 100% technical success rates and 89% clinical success rates. No events of nontarget embolization or other procedure-related complications were noted. The mortality & morbidity rates were 0%. The loss to follow up rate was 16% (9 /54). The mean follow-up period was 134 days (range, 30 to 522 days).ConclusionThe single institutional experience supports the safety and efficacy of EVOH embolization in the treatment of various peripheral vascular conditions.

Highlights

Ethylene Vinyl Alcohol Copolymer, ethylene vinyl alcohol (EVOH) (OnyxTM, Medtronic, Minneapolis, MN) is a non-adhesive, nonabsorbable, permanent liquid embolic agent
Other rare off-label uses of EVOH include embolization of gastrointestinal hemorrhage (Urbano et al, 2014), post-traumatic hemorrhage (Müller-Wille et al, 2011), type I endoleaks (Eberhardt et al, 2014), pulmonary hemorrhages (Bommart et al, 2011; Izaaryene et al, 2016), pseudoaneurysms (PSAs) (Vanninen & Manninen, 2007), pelvic arteriovenous malformations (AVMs) (Castaneda et al, 2002; Wohlgemuth et al, 2015), and neoplasms. (Regine et al, 2015) The existing literature is in the form of case reports or series
Over a period of 7 years, we identified 43 patients who underwent embolization with EVOH for peripheral vascular pathologies

Summary

Introduction

Ethylene Vinyl Alcohol Copolymer, EVOH (OnyxTM, Medtronic, Minneapolis, MN) is a non-adhesive, nonabsorbable, permanent liquid embolic agent. The possible reasons for the slow adoptation of this agent in the treatment of peripheral pathologies could be secondary to its perceived technical complexity, inadequate training, feared complications, high (2020) 3:38 cost and lack of data demonstrating its efficacy and safety profile. The purpose of this retrospective review was to evaluate the safety and efficacy profile of EVOH in the treatment of peripheral vascular conditions and contribute the results of this retrospective review to an existing literature

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