Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis.
Publication/Presentation Date
8-1-2026
Abstract
BackgroundA wide range of liquid embolic agents has been used in endovascular treatment (EVT) of dural arteriovenous fistulas (dAVFs) and cerebral arteriovenous malformations (cAVMs). Newer liquid embolics, Squid (Balt) and PHIL (MicroVention), aim to improve the safety and efficacy of EVT of dAVFs and cAVMs.ObjectiveTo assess the safety and efficacy of EVT of cAVMs and dAVFs using Squid or PHIL as an embolic agent.MethodsWe searched major databases following PRISMA guidelines and included studies with ≥ five patients reporting on EVT of dAVFs and/or cAVMs using Squid or PHIL as embolic agent. We analyzed efficacy outcomes including complete occlusion, incomplete occlusion, and recurrence at follow up, and safety outcomes including procedure-related complications, morbidity, and mortality with a random-effects meta-analysis. Separate analyses were performed for cAVMs and dAVFs. Subanalyses were conducted for studies exclusively utilizing PHIL and those exclusively utilizing Squid, for both cAVMs and dAVFs.ResultsTen studies, comprising 214 patients (53.7% male), were found. Of these, 113 patients had 113 dAVFs, while 101 patients had 101 cAVMs. Complete occlusion rates following embolization were 91% for dAVFs and 32% for cAVMs. A subanalysis of dAVFs embolized solely with Squid and PHIL identified 93% and 86% complete occlusion rates, respectively. The overall procedure-related permanent morbidity rate was 3% for dAVFs and 7% for cAVMs. There was only one procedure-related mortality, which developed in a cAVM case, across 214 cases.ConclusionSquid and PHIL are safe and effective embolic agents for treatment of dAVFs and cAVMs.
Volume
32
Issue
4
First Page
1786
Last Page
1795
ISSN
2385-2011
Published In/Presented At
Günkan, A., Ferreira, M. Y., Vilardo, M., Scarcia, L., Bocanegra-Becerra, J. E., Alexandre, A., Ferreira, C., Dmytriw, A., Ciccio, G., Clarençon, F., Jabbour, P., & Serulle, Y. (2026). Safety and efficacy of newer liquid embolic agents Squid and PHIL in endovascular embolization of cerebral arteriovenous malformations and dural arteriovenous fistulas: A systematic review and meta-analysis. Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 32(4), 1786–1795. https://doi.org/10.1177/15910199241288897
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
39569607
Department(s)
Administration and Leadership
Document Type
Article