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Background: Endovascular therapy with liquid embolic agents (LEAs) is the gold standard for the treatment of cerebral dural arteriovenous fistulas (cDAVFs). The aim of the study is to retrospectively evaluate effectiveness, safety, and midterm follow-up results of endovascular treatment of cDAVFs using SQUID 12. Methods: Between June 2017 and January 2020 the authors retrospectively reviewed clinical, demographic and embolization data of 19 consecutive patients with cDAVF who underwent embolization using SQUID 12. The number of arteries catheterized for each procedure, the total amount of embolic agent, the occlusion rate, the injection time, any technical and/or clinical complications were recorded. Mid-term follow-up with DSA was reviewed. Results: 20 procedures were performed in 19 patients. A transarterial approach was accomplished in 19 procedure; a combined transvenous-transarterial approach was realized in 1 treatment. The average time of injection was 33 minutes (2–82 minutes), and the average amount of SQUID 12 was 2.8 mL (0.5–6 mL). Complete angiographic cure at the end of the procedure was achieved in 17 patients. No major periprocedural adverse events were recorded. Mid-term follow-up was achieved in 15 out of 19 patients and confirmed complete occlusion of the cDAVFs in 13/15 patients (87%); in 2 of the initially cured patients a small relapse was detected. Conclusions: The treatment of the cDAVFs using SQUID 12 was effective and safe. The lower viscosity seems to allow an easier penetration of the agent with a high rate of complete occlusion of the cDAVFs. [ABSTRACT FROM AUTHOR]

Objective: The authors have evaluated their experience in pre-operative direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12, an embolic liquid agent. Methods: Between July 2016 and March 2019, the authors retrospectively reviewed clinical, embolization and surgical data of 11 consecutive patients with 12 hypervascular head and neck tumors who had undergone pre-operative embolization using SQUID 12. Percutaneous embolizations were performed by inserting a 19-22 Gauge needle directly into the tumor under ultrasound, fluoroscopic and/or endoscopic guidance. The hub of the needle was connected to a 15-cm DMSO-compatible extension tube, and the SQUID 12 was injected. Results: Total or near-total devascularization was achieved in 11 over 12 cases. Complete en-bloc tumor removal by surgery was achieved in all cases. Only one patient required blood transfusion. No major periprocedural adverse events were recorded. Conclusions: Direct puncture embolization of hypervascular tumors of the head and neck using SQUID 12 seems to be safe and effective. It may offer almost complete devascularization due to homogenous, deep penetration in the tumor, with optimal visibility of the agent throughout the percutaneous procedure. It may reduce intraoperative blood loss and the need for transfusion, thus facilitating complete surgical resection. [ABSTRACT FROM AUTHOR]

Introduction: We report our experience with the novel stent-type clot-retrieval device EmboTrap II for the revascularization of large artery occlusions in acute ischaemic stroke. Materials and methods: Twenty-nine patients with acute ischaemic stroke due to large artery occlusion underwent mechanical thrombectomy with the new EmboTrap II in two Italian centres. Clinical, procedural and radiological data were collected. Angiographic results and neurological outcomes were analysed. Results: Only large vessel occlusions were included. Intravenous thrombolysis was administered in 72% of patients. Successful reperfusion (TICI 2b-3) was obtained in 76% of patients treated exclusively with EmboTrap II. No device-related permanent complications occurred. Conclusion: In our experience, mechanical thrombectomy with EmboTrap II is safe and effective. Reperfusion rate was comparable to that obtained with other stent retrievers. [ABSTRACT FROM AUTHOR]

Background The Barrel vascular reconstruction device is an electrolytically detachable laser-cut closed-cell stent used for neck reconstruction in wide-necked bifurcation aneurysms to support coiling without necessitating dual stent implantation. The purpose is to lower the metal-to-artery ratio and its inherent risk of thromboembolic complications of multiple stents. Case description A 53-year-old woman presenting with subarachnoid hemorrhage due to acutely ruptured basilar tip aneurysm underwent emergency endovascular embolization with the Barrel vascular reconstruction device. Since the stent did not cover the entire neck of the aneurysm, an Atlas stent was released in a Y configuration through the Barrel. The Neuroform Atlas correctly opened through the Barrel and allowed the complete exclusion of the aneurysm. Conclusion If necessary, releasing a Neuroform Atlas through a Barrel vascular reconstruction device is a feasible technique. [ABSTRACT FROM AUTHOR]