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LIQUID - Treatment of High-grade Dural Arteriovenous Fistulas with Squid Liquid Embolic Agent: a Prospective, Observational Multicenter Study

by Dominik Vollherbst, Tobias Boppel, Marta Wallocha, Ansgar Berlis, Christoph J. Maurer, Werner Weber, Sebastian Fischer, Alexander Bock, Stephan Meckel, Georg Bohner, Thomas Liebig, Christian Herweh, Martin Bendszus, René Chapot, Markus Alfred Möhlenbruch · 2023

ISBN:  Unavailable

Category: Unavailable

Page count: Unavailable

Abstract: Background: Endovascular embolization is a feasible treatment for cranial dural arteriovenous fistulas (DAVFs). New embolic agents aim to improve the success of DAVF embolization.<br><br>Objective: To assess the safety, efficacy, and short-term outcome of the treatment of DAVFs using the new liquid embolic agent Squid.<br><br>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.<br><br>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%).<br><br>Conclusion: Squid is a safe and effective liquid embolic agent for the treatment of high-grade DAVFs