Turkish Neurosurgery 2014 , Vol 24 , Num 4
Preliminary Experience with Squid: A New Liquid Embolizing Agent for Avm, Av Fistulas and Tumors
Ilkay AKMANGIT1, Ergun DAGLIOGLU2, Tunca KAYA1, Fatih ALAGOZ2, Mert SAHINOGLU2, Ahmet PEKER3, Shehram DERAKSHANI4, Dogan DEDE1, Deniz BELEN2, Anil ARAT5
1Ankara Numune Education and Research Hospital, Department of Radiology, Ankara, Turkey
2Ankara Numune Education and Research Hospital, Department of Neurosurgery, Ankara, Turkey
3Ankara University, School of Medicine, Department of Radiology, Ankara, Turkey
4Queen’s University Hospital, Diagnostic, Interventional and Therapeutic Radiology, London, United Kingdom
5Hacettepe University, School of Medicine, Department of Radiology, Ankara, Turkey
DOI : 10.5137/1019-5149.JTN.11179-14.0 AIM: The aim of the present study was to analyze our experience with a new liquid embolic agent, Squid, for the treatment of cerebral vascular lesions.

MATERIAL and METHODS: We present 28 patients who were treated with two formulations of Squid (Squid 18 and Squid 12). The lesions included 16 arteriovenous malformation (AVM)s (Spetzler-Martin grade 2 in 8, 3 in 6 and 4 in 2), 9 arteriovenous (AV) fistulas, 2 tumors (glomus tumor and angiofibroma) and 1 AICA aneurysm. Of the 9 patients presenting with hemorrhage, 6 were AVM, 2 were AVF and 1 was aneurysm.

RESULTS: The total obliteration rate of the AVMs was 37.5%. Fistulas were closed completely after combined treatment with surgery in 6 out of 9 patients, and one was sent to radiotherapy. There was no mortality. Two reported hemorrhages and thromboembolic complications resulted in permanent deficits in 3 patients. Pathologic examination revealed mild inflammatory reaction with infiltration of polymorphonuclear cells in 5 patients in whom surgery was performed immediately after embolization. Technical problems such as rupture, inability to remove or premature occlusion of the microcatheter related to the embolic agent were not recorded.

CONCLUSION: Squid is a safe and effective embolic agent for treatment of cerebral AVMs, AV fistulas, tumors and aneurysms with satisfactory obliteration rate. Keywords : Squid, Cerebral arteriovenous malformation, Intracranial AVM, Intracranial AV fistula, Tumor, Embolization

Corresponding author : Ergun Daglıoglu, edaglioglu@gmail.com