SIR 2024
Embolization
Kenneth Huynh, DO
Resident
University of California, Irvine
Financial relationships: Full list of relationships is listed on the CME information page.
Rebecca Bennett, MD
Disclosure information not submitted.
Theodore Bryan, MD
Assistant Clinical Professor
University of California, Irvine
Disclosure information not submitted.
Christina Boyd, MD (she/her/hers)
Assistant Clinical Professor of Interventional Radiology
University of California Irvine
Disclosure information not submitted.
Simon Long, MD
Assistant Clinical Professor
University of California, Irvine
Disclosure information not submitted.
Dayantha Fernando, MD
Clinical Professor
Interventional Radiology Residency Program Director
University of California Irvine
Disclosure information not submitted.
Nadine Abi-Jaoudeh, MD, FSIR
Professor of Radiology
University of California
Financial relationships: Full list of relationships is listed on the CME information page.
Liquid embolic agents can conform to vessel shapes, penetrate deeper into vascular networks, are radiopaque, and have calibrated viscosities {1–3}. Given these properties, liquid embolics often provide precise and complete vessel occlusion {3,4}. Common types of liquid embolics include sclerosing agents, lipiodol, N-butyl cyanoacrylate, and Onyx. New advancements in liquid embolics provide enhanced radiopacity, faster polymerization rates, and improved biocompatibility. Novel liquid embolics include precipitating hydrophobic injectable liquids (PHIL), Squid, and hydrogels. Emerging formulations based on nanotechnology and smart materials have shown the potential for targeted delivery and even drug-eluting capabilities {1–3,5}. Clinical outcomes have shown reduced procedural times, lower complication rates, and improved long-term efficacy in the management of a wide spectrum of vascular diseases {1–3,5}. A case-based review of the uses of liquid embolics in multiple scenarios, including vascular malformations, oncologic therapies, and acute hemorrhage will be presented. Complications of liquid embolics, such as non-target embolization, migration, catheter entrapment, and recanalization will be discussed.
Conclusion and/or Teaching Points:
Advances in liquid embolic agents are leading to safer, more efficient, and versatile embolization procedures. As these agents continue to evolve, liquid embolics have the potential to redefine endovascular treatments. It is prudent for the interventional radiologist to understand the uses of each liquid embolic agent and their working properties to optimize their application.