PMID- 36609544
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231023
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Print)
IS  - 1759-8478 (Linking)
VI  - 15
IP  - 11
DP  - 2023 Nov
TI  - LIQUID - Treatment of high-grade dural arteriovenous fistulas with Squid liquid 
      embolic agent: a prospective, observational multicenter study.
PG  - 1111-1116
LID - 10.1136/jnis-2022-019859 [doi]
AB  - BACKGROUND: Endovascular embolization is a feasible treatment for cranial dural 
      arteriovenous fistulas (DAVFs). New embolic agents aim to improve the success of 
      DAVF embolization. OBJECTIVE: To assess the safety, efficacy, and short-term 
      outcome of the treatment of DAVFs using the new liquid embolic agent Squid. 
      METHODS: The LIQUID study is a prospective, observational multicenter study on 
      the treatment of high-grade (Cognard type >/=3) DAVFs with the embolic agent Squid. 
      The primary outcome measures were safety (ie, morbidity and mortality), as well 
      as the occlusion rate 90 to 180 days after treatment. RESULTS: In eight centers, 
      53 patients (mean age 59.8 years, 22.6% female) were treated in 55 treatment 
      sessions. Of the DAVFs, 56.6% were Cognard type III, 41.5% type IV, and 18.9% 
      were ruptured. Squid 18 was used in 83.6% and Squid 12 in 32.7% of the 
      treatments. The overall rate of intraprocedural or postprocedural adverse events 
      (AEs) was 18.2%. Procedure-related AEs resulting in permanent morbidity were 
      observed in 3.6%. One patient (1.8%) died unrelated to the procedure due to 
      pulmonary embolism. The final complete occlusion rate at 90 to 180 days was 
      93.2%. After a mean follow-up of 5.5 months, the modified Rankin Scale (mRS) 
      score was stable or improved in 93.0%. In one of the patients, worsening of the 
      mRS score was related to the procedure (1.8%). CONCLUSION: Squid is a safe and 
      effective liquid embolic agent for the treatment of high-grade DAVFs.
CI  - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Vollherbst, Dominik F
AU  - Vollherbst DF
AUID- ORCID: 0000-0002-8992-4757
AD  - Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, 
      Germany.
FAU - Boppel, Tobias
AU  - Boppel T
AD  - Institute of Neuroradiology, University Hospitals Schleswig-Holstein, Campus 
      Lubeck, Luebeck, Germany.
FAU - Wallocha, Marta
AU  - Wallocha M
AD  - Neuroradiology, Alfried Krupp Krankenhaus Ruttenscheid, Essen, Germany.
FAU - Berlis, Ansgar
AU  - Berlis A
AD  - Department of Diagnostic and Interventional Neuroradiology, Universitatsklinikum 
      Augsburg, Augsburg, Germany.
FAU - Maurer, Christoph J
AU  - Maurer CJ
AUID- ORCID: 0000-0002-0305-0797
AD  - Department of Diagnostic and Interventional Neuroradiology, Universitatsklinikum 
      Augsburg, Augsburg, Germany.
FAU - Weber, Werner
AU  - Weber W
AD  - Department of Neuroradiology, Universitatsklinikum Knappschaftskrankenhaus 
      Bochum, Bochum, Germany.
FAU - Fischer, Sebastian
AU  - Fischer S
AD  - Department of Neuroradiology, Universitatsklinikum Knappschaftskrankenhaus 
      Bochum, Bochum, Germany.
FAU - Bock, Alexander
AU  - Bock A
AD  - Department of Neuroradiology, Vivantes Hospital, Berlin, Germany.
FAU - Meckel, Stephan
AU  - Meckel S
AD  - Department of Neuroradiology, University of Freiburg, Freiburg, Germany.
AD  - Institute of Diagnostic and Interventional Neuroradiology, RKH Kliniken 
      Ludwigsburg, Ludwigsburg, Germany.
FAU - Bohner, Georg
AU  - Bohner G
AD  - Department of Neuroradiology, University Hospital of Berlin (Charite), Berlin, 
      Germany.
FAU - Liebig, Thomas
AU  - Liebig T
AD  - Institute of Diagnostic and Interventional Neuroradiology, University Hospital, 
      LMU Munich, Munchen, Germany.
FAU - Herweh, Christian
AU  - Herweh C
AD  - Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, 
      Germany.
FAU - Bendszus, Martin
AU  - Bendszus M
AD  - Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, 
      Germany.
FAU - Chapot, Rene
AU  - Chapot R
AUID- ORCID: 0000-0002-2584-8361
AD  - Neuroradiology, Alfried Krupp Krankenhaus Ruttenscheid, Essen, Germany.
FAU - Mohlenbruch, Markus A
AU  - Mohlenbruch MA
AD  - Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany 
      markus.moehlenbruch@med.uni-heidelberg.de.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20230106
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
RN  - 25067-34-9 (ethylene-vinyl alcohol copolymer)
RN  - 0 (Polyvinyls)
SB  - IM
MH  - Humans
MH  - Female
MH  - Middle Aged
MH  - Male
MH  - Prospective Studies
MH  - Treatment Outcome
MH  - *Central Nervous System Vascular Malformations/diagnostic 
      imaging/therapy/etiology
MH  - *Embolization, Therapeutic/adverse effects/methods
MH  - Polyvinyls
MH  - Retrospective Studies
PMC - PMC10579477
OTO - NOTNLM
OT  - Arteriovenous Malformation
OT  - Device
OT  - Fistula
OT  - Liquid Embolic Material
OT  - Vascular Malformation
COIS- Competing interests: DFV reports consultancy for Medtronic and payed lectures for 
      Cerenovus, and a research grant by MicroVention (unrelated to this work). TB 
      reports payment for lectures and presentations from Stryker, Penumbra, and 
      support for attending meeting and/or travel from Phenox, Microvention, and 
      Stryker in the last 3 years. ABe reports proctoring for Microvention, Stryker, 
      and Medtronic; payments for lectures for Stryker, Phenox and Penumbra; and board 
      fees for CEC (Phenox) and Bayer. SM reports consultancy for Stryker, Medtronic, 
      Acandis GmbH, Novartis Pharma GmbH (unrelated to study) and a travel grant by 
      Balt (unrelated to study). TL has proctored and consulted for CERUS, Stryker, 
      Phenox, Acandis, Medtronic, Pfizer and Microvention within the past three years 
      but has no direct conflict of interest in the realm of this study. MB reports the 
      following conflicts of interest outside the present work: board membership: DSMB 
      Vascular Dynamics; consultancy: Roche, Guerbet, Codman; grants/grants pending: 
      DFG, Hopp Foundation, Novartis, Siemens, Guerbet, Stryker, Covidien; payment for 
      lectures (including service on speakers bureaus): Novartis, Roche, Guerbet, Teva, 
      Bayer, Codman. MAM has received consulting honoraria, speaker honoraria, and 
      travel support outside this work from Codman, Covidien/Medtronic, MicroVention, 
      Phenox, and Stryker. The other authors declared no specific conflict of interest.
EDAT- 2023/01/08 06:00
MHDA- 2023/10/23 00:42
PMCR- 2023/10/17
CRDT- 2023/01/07 16:35
PHST- 2022/11/09 00:00 [received]
PHST- 2022/12/19 00:00 [accepted]
PHST- 2023/10/23 00:42 [medline]
PHST- 2023/01/08 06:00 [pubmed]
PHST- 2023/01/07 16:35 [entrez]
PHST- 2023/10/17 00:00 [pmc-release]
AID - jnis-2022-019859 [pii]
AID - 10.1136/jnis-2022-019859 [doi]
PST - ppublish
SO  - J Neurointerv Surg. 2023 Nov;15(11):1111-1116. doi: 10.1136/jnis-2022-019859. 
      Epub 2023 Jan 6.