Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22566
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dc.contributor.authorRyan, Stewart D-
dc.contributor.authorNambiar, Anjali-
dc.contributor.authorMaingard, Julian T-
dc.contributor.authorKok, Hong Kuan-
dc.contributor.authorTurner, Robert B S-
dc.contributor.authorBrooks, Duncan Mark-
dc.contributor.authorAsadi, Hamed-
dc.date2019-08-01-
dc.date.accessioned2020-02-11T01:18:15Z-
dc.date.available2020-02-11T01:18:15Z-
dc.date.issued2019-08-01-
dc.identifier.citationCVIR endovascular 2019; 2(1): 27-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/22566-
dc.description.abstractHepatic arteriovenous malformations (HAVMs) are rare congenital lesions consisting of multiple high-pressure arteries feeding into low-pressure veins via a central nidus. Massive haemorrhage, portal hypertension and hepatic insufficiency can ensue. Endovascular embolization is increasingly a first line treatment method although there is no general consensus or guidelines on the most effective embolic agent or approach. We describe the novel treatment of two dogs with congenital hepatic AVMs using a modified version of the 'pressure cooker' technique often utilised in neurointervention with the DMSO-based PHIL embolic agent delivered via the DMSO compatible Scepter-XC dual lumen balloon catheter. Two paediatric dogs were diagnosed with hepatic AVMs. Both dogs presented with ascites and abnormal liver function tests. CT angiograms revealed hepatic arterio-portal malformations arising from an enlarged celiac artery. Selective catheterisation of the artery supplying the AVM was achieved via a femoral artery approach. A Scepter XC dual-lumen compliant balloon microcatheter and Traxcess 0.014 guidewire combination was advanced to the nidus via through the 5Fr guide catheter towards the nidus. Inflation of the balloon occluded arterial inflow and PHIL was injected under continuous fluoroscopic screening until the PHIL embolic agent penetrated into the draining portal vein beyond the nidus. In patient 1, normal portal venous waveform was restored with reversal of severe hepatic insufficiency. Whilst there was initial improvement post-operatively in patient 2 with normalisation of portal vein pressures and flow, opening of collateral nidus vessels re-established the high-pressure communication, and euthanasia was elected by the owner. The 'pressure cooker' technique is a safe and efficacious approach to the treatment of canine HAVMs. The novel use of PHIL and the Scepter XC balloon catheter has several advantages over conventional endovascular approaches. Translational application to human paediatric interventions for similar conditions where embolic and contrast agent volume constraints are similar can be considered.-
dc.language.isoeng-
dc.subjectHepatic arteriovenous malformation-
dc.subjectLiquid embolic-
dc.subjectPHIL-
dc.subjectScepter XC-
dc.titleEndovascular embolization of canine hepatic arteriovenous malformations using precipitating hydrophobic injectable liquid (PHIL) liquid embolic agent: a proof of concept study.-
dc.typeJournal Article-
dc.identifier.journaltitleCVIR endovascular-
dc.identifier.affiliationTRACTS, UVet Hospital, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationSchool of Medicine and Dentistry, James Cook University, Townsville, Australiaen
dc.identifier.affiliationInterventional Neuroradiology Unit, Monash Health, Melbourne, Australiaen
dc.identifier.affiliationTRACTS, UVet Hospital, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australiaen
dc.identifier.affiliationInterventional Radiology Service, Northern Hospital Radiology, Melbourne, Australiaen
dc.identifier.affiliationInterventional Radiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationInterventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationSchool of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australiaen
dc.identifier.doi10.1186/s42155-019-0070-4-
dc.identifier.orcid0000-0003-2475-9727en
dc.identifier.orcid0000-0001-8958-2411en
dc.identifier.orcid0000-0001-7016-771Xen
dc.identifier.pubmedid32026126-
dc.type.austinJournal Article-
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