{
  "abstract": "Background and Purpose Embolization is the first-line treatment for dural arteriovenous fistulas (dAVF). The precipitating hydrophobic injectable liquid (PHIL) embolic agent is a non-adhesive copolymer with specific features and endovascular behavior. This study assessed its safety and efficacy in a prospective real-life cohort.Methods The PHIL-dAVF study was a prospective single-arm open-label observational multicenter study conducted between October 2017 and November 2019 in 14 European centers. Patients with a single intracranial dAVF intended for PHIL embolization were included. Previously partially treated or multiple dAVFs were excluded. Additional devices and embolic agents were permitted as complementary techniques or second-line strategies. Primary endpoints were functional outcome changes from baseline and complete cure rate at 3–6 months after the last embolization. Safety was assessed by adverse events (AE) incidence.Results A total of 67 patients (77 endovascular procedures; 70.1% men, mean age 61±14 years) were included. Most DAVFs were unruptured (71.6%), located in the transverse/sigmoid sinus (53.7%) and Cognard grade III or IV (56.7%). Sixty patients (89.6%) received one single embolization. Additional devices were used in 31.2% of procedures. Complete angiographic cure rate was 86.9% at the 3–6 month DSA follow-up after the last endovascular treatment. At least one AE was recorded in 37.3% of patients during follow-up, of which 52.9% were related to the procedure. The procedural rates of AE and serious AE were 32.5% and 15.6%, respectively. Five AEs were related to PHIL. Transient functional deterioration occurred in three patients (4.5%), all resolved by the last follow-up.Conclusion The PHIL-dAVF study provides evidence about the efficacy and safety of PHIL in the treatment of intracranial dAVFs, with outcomes comparable to existing liquid embolic agents reported in the literature.",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology Department, CHU Bordeaux GH Pellegrin, Bordeaux, France"
      ],
      "name": "Gaultier Marnat"
    },
    {
      "affiliations": [
        "Neuroradiology Department, CHU Bordeaux GH Pellegrin, Bordeaux, France"
      ],
      "name": "Xavier Barreau"
    },
    {
      "affiliations": [
        "Neuroradiology, CHU Toulouse, Toulouse, France"
      ],
      "name": "Anne-Christine Januel"
    },
    {
      "affiliations": [
        "NEURI The Brain Vascular Center, Bicetre Hospital Interventional Neuroradiology, Le Kremlin-Bicetre, France",
        "Paris-Saclay University Faculty of Medicine, Le Kremlin-Bicetre, France"
      ],
      "name": "Laurent Spelle"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France"
      ],
      "name": "Michel Piotin"
    },
    {
      "affiliations": [
        "Radiology, Dupuytren Hospital, Limoges, France"
      ],
      "name": "Charbel Mounayer"
    },
    {
      "affiliations": [
        "Neuroradiology Department, Uppsala University, Uppsala, Sweden"
      ],
      "name": "Ljubisa Borota"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Virgen del Rocío University Hospital, Seville, Spain"
      ],
      "name": "Alejandro González"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Universitario Quironsalud Madrid, Madrid, Spain",
        "Interventional Neuroradiology, Hospital de Nuestra Señora del Rosario, Madrid, Spain"
      ],
      "name": "Alfredo Casasco"
    },
    {
      "affiliations": [
        "DCN, NHS Lothian, Edinburgh, UK"
      ],
      "name": "Peter Keston"
    },
    {
      "affiliations": [
        "Imaging Department, Imperial College Healthcare NHS Trust, London, UK"
      ],
      "name": "Kyriakos Lobotesis"
    },
    {
      "affiliations": [
        "Neuroradiology and Radilogy, Umeå University Hospital Sweden, Umeå, Sweden"
      ],
      "name": "Mats Cronqvist"
    },
    {
      "affiliations": [
        "Neuroradiology, Rigshospitalet, Copenhagen, Denmark"
      ],
      "name": "Markus Holtmannspötter"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital General de Catalunya, Neuroangiografia Terapeutica, Barcelona, Spain"
      ],
      "name": "Leopoldo Guimaraens"
    },
    {
      "affiliations": [
        "Neuroradiology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy"
      ],
      "name": "Edoardo Boccardi"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Ospedale San Carlo Borromeo, Milano, Italy"
      ],
      "name": "Luca Valvassori"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain"
      ],
      "name": "Mariano Espinosa de Rueda"
    },
    {
      "affiliations": [
        "Diagnostic and Therapeutic Neuroradiology, Hôpital Purpan, Toulouse, France"
      ],
      "name": "Christophe Cognard"
    },
    {
      "affiliations": [],
      "name": "on behalf of the PHIL-dAVF study investigators"
    }
  ],
  "title": "Efficacy and safety of the PHIL embolic agent in the treatment of intracranial dural arteriovenous fistulas: results of the PHIL-dAVF study",
  "uid": "a26fe059-6a5a-5448-83f3-8618dfbf0cef"
}