Eudragit-E was originally developed as a non-adhesive liquid embolic material in the late 1990s and is a copolymer of methyl and butyl methacrylate and dimethylaminoethyl methacrylate that is dissolved in ethanol and iopamidol. This material has been used for endovascular embolization of brain arteriovenous malformations (AVMs) for some time but is currently not widely used. Because safety and feasibility of Eudragit-E has not been well documented, we here report our experience using this material for treating 22 human brain AVMs. From June 1998 to February 2014, 30 endovascular procedures using Eudragit-E were performed to treat 22 patients, including 14 men and 8 women with a mean age of 41.1 years (15-70 years). The mean follow-up period was 56 months (12-129 months), and the Spetzler-Martin grades were I (4 patients), II (9 patients), III (5 patients), and IV (4 patients). Residual AVMs were treated with stereotactic radiosurgery or surgery. The rate of complete obliteration with embolization alone was 27.3%. The overall obliteration rate after endovascular embolization with/without subsequent stereotactic radiosurgery or surgery was 72.7%. Eudragit-E caused two cases of cerebral infarction. One case of intracerebral hemorrhage due to postoperative hemodynamic changes also occurred. The rate of complications directly related to embolization was 10.0%. The safety and effectiveness of Eudragit-E embolization were satisfactory.
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http://dx.doi.org/10.2176/nmc.oa.2014-0287 | DOI Listing |
World Neurosurg
January 2025
Department of Neurology, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou 434000, China. Electronic address:
Objective: This study was to explore the factors associated with prolonged hospital length of stay (LOS) in patients with intracranial aneurysms (IAs) undergoing endovascular interventional embolization and construct prediction model machine learning algorithms.
Methods: Employing a retrospective cohort study design, this study collected patients with ruptured IA who received endovascular treatment at Jingzhou First People's Hospital during the inclusion period from September 2022 to December 2023. The entire dataset was randomly split into training and testing dataset with a 7:3 ratio.
J Neurointerv Surg
January 2025
Intervention Neuroradiology, CHU Limoges, Limoges, Aquitaine-Limousin-Poitou-Charentes, France
Background: Hemorrhage is a major complication of brain arteriovenous malformations (AVMs) embolization, which can be related to persistent arteriovenous shunts that were not completely occluded during the embolization. In transvenous embolization (TVE) this risk is deemed higher for AVMs larger than 3 cm featuring multiple veins of drainage. Herein, we will discuss a few selected cases where brain AVMs with more than one draining vein were deemed safe for curative embolization with advanced endovascular techniques after a careful anatomical study through the four dimensional-digital subtraction angiography (4D-DSA) imaging.
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Lyerly Neurosurgery, Baptist Medical Center Jacksonville, Jacksonville, Florida, USA
The Artisse intrasaccular device (Medtronic) offers a novel treatment option for unruptured and ruptured wide-neck bifurcating intracranial aneurysms.1 2The Artisse device features enhancements including a distal tip for dome protection, platinum band markers for improved visibility, and a bilayer high-density platinum core nitinol mesh basket for enhanced flexibility and visibility when compared with previous devices.2-7 Data from case series demonstrate the procedural safety and efficacy of the Artisse device.
View Article and Find Full Text PDFFront Surg
December 2024
School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Background: Current guidelines recommend preserving at least one of the bilateral pelvic flows in patients with aortoiliac aneurysms. The sandwich parallel graft, using commercially available devices, provides a viable option for patients who fall outside the instructions for use of iliac branch devices. However, gutter endoleak remains a significant challenge.
View Article and Find Full Text PDFA A Pract
January 2025
Department of Anesthesiology, University of Kansas Medical Center, Kansas City, Kansas.
Transcatheter aortic valve replacement (TAVR) is a common treatment for severe aortic stenosis (AS), but it carries the risk of severe complications, including device embolization. We present a case of a TAVR valve embolization into the left ventricular outflow tract (LVOT), diagnosed with transesophageal echocardiography (TEE) shortly after device deployment. The dislodged valve was successfully retrieved from the LVOT into the aorta, flattened, and stabilized with a thoracic endovascular aneurysm repair (TEVAR) stent, enabling the successful implantation of a new TAVR valve.
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