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  • Initial experience with the new ethylene vinyl alcohol copolymer based liquid embolic agent Menox in the endovascular treatment of cerebral arteriovenous malformations

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New Devices and Techniques
Case series
Initial experience with the new ethylene vinyl alcohol copolymer based liquid embolic agent Menox in the endovascular treatment of cerebral arteriovenous malformations
  1. Stanimir Sirakov1,
  2. Alexander Sirakov1,
  3. Krasimir Minkin2,
  4. Marin Penkov1,
  5. Kristian Ninov3,
  6. Hristo Hristov2,
  7. Vasil Karakostov3,
  8. Radoslav Raychev4
  1. 1 Radiology Department, UH St Ivan Rilski, Sofia, Bulgaria
  2. 2 Neurosurgery Department, UH St Ivan Rilski, Sofia, Bulgaria
  3. 3 Neurosurgery Department, UH St Ivan Rilski, Sofia, Bul Akad Ivan Geshov 15, Bulgaria
  4. 4 Department of Neurology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
  1. Correspondence to Dr Radoslav Raychev, Neurology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA 90095, USA; rudoray{at}gmail.com

Abstract

Background and Purpose Liquid embolic agents (LEAs) are the determinant tool for successful embolization of cranial arteriovenous shunts. There are few currently available LEAs. The aim of the study was to summarize our initial experience with a recently introduced non-adhesive ethylene vinyl alcohol (EVOH) copolymer based LEA (Menox 18) in the endovascular treatment of cerebral arteriovenous malformations.

Methods From April 2018 to November 2018, 24 patients harboring cerebral arteriovenous malformations underwent endovascular embolization with Menox 18. Clinical features, angiographic results, procedural details, complications, and follow-up details were prospectively collected and retrospectively analyzed.

Results Curative embolization in one endovascular session was achieved in 14/24 (58.3%) of the treated patients. Partial embolization was achieved in 10 patients (42.6%) in whom staged treatment with radiosurgery or microsurgical resection was planned. No mortality was recorded in our series. Clinical complications after embolization occurred in 1/24 (4.66%) patients. No technical complications were noted

Conclusions Our pilot study suggests that the Menox embolization system offers similar technical and clinical results in comparison with the other currently available LEAs. Further studies with larger cohorts and long term follow-up data are needed to fully evaluate its efficacy

  • liquid embolic material
  • arteriovenous malformation
  • device

https://doi.org/10.1136/neurintsurg-2019-014963

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    Footnotes

    • Contributors The main author interpreted the data, drafted the original manuscript version, reviewed all suggestions provided by all co-authors, approved the final version, and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The senior author provided major edits and assumed responsibility for final review and submission as a corresponding author. All co-authors provided substantial contribution to the interpretation of the provided data. All co-authors also contributed with revisions to the original draft, approved the final version of the manuscript, and agreed to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data related to this manuscript are available upon request.

    • Patient consent for publication Not required.