Percutaneous Embolization of Scalp Arteriovenous Malformation Using New Liquid Embolic Agent, SQUID: A Technical Report

Abstract

Scalp arteriovenous malformations (AVMs) are rare extracranial vascular malformations that are traditionally treated by surgical excision or by combined endovascular-surgical approaches. We describe percutaneous treatment of scalp AVM, using a new liquid embolic agent, SQUID. Because of its nonadhesive property, prolonged injection and complete obliteration of scalp AVM is feasible. The cast formed is aesthetically appealing to the patient, and it may obviate the need for further surgical excision. It could be considered as the primary treatment option for patients unwilling for surgery.

Liquid Embolic Agents for Endovascular Embolization: A Review

“…Table 1 summarizes the liquid embolics that are discussed in this review. Shear-Thinning Biomaterials [88,89] Silk Elastin Protein (SELP) [90][91][92] Poly(Ethylene Glycol) Hydrogel Embolization System (HES) Instylla Embrace [92][93][94][95][96] Eudragit [97][98][99][100] Calcium Alginate [101][102][103][104][105][106] Ethylene vinyl alcohol copolymers Squid and Squid Peri [107][108][109][110][111][112][113][114][115][116][117] Onyx Poly(lactide-co-glycolide) and poly(hydroxyethyl methacrylate) PHIL [159][160][161][162][163][164][165][166][167] Iodinated polyvinyl alcohol EASYX [168][169][170][171] 3.1. Polymerizing Liquid Embolics…”

“…Overall, Squid was reported to be a safe and effective embolic agent for the treatment of cerebral AVMs and AV fistulas with satisfactory obliteration rate. In 2017, Kannath et al reported the use of Squid as a liquid embolic for the percutaneous embolization of scalp arteriovenous malformations [110], which are traditionally treated by surgical approaches. Complete obliteration of scalp AVM was possible due to the nonadhesive nature of Squid and the formed cast was aesthetically appealing to the patient.…”