Liquid embolic agents have been used for several years in the treatment of arteriovenous malformations (AVMs). The traditional method of treatment involved surgery, which carried significant risk and was not always successful. Liquid embolic agents have become a popular option due to their minimally invasive nature, ease of use, and effectiveness. This paper aims to review recent progress in liquid embolic agents and their potential applications in the field of neurointervention.
Liquid embolic agents are classified based on their mechanism of action and composition. The most commonly used liquid embolic agents are cyanoacrylates, Lava, and glue. Cyanoacrylates are a type of adhesive that polymerize upon contact with blood, forming a solid embolic mass. Lava is a non-adhesive liquid embolic agent that polymerizes upon contact with an aqueous solution, creating a solid embolic mass. Glue is a type of adhesive that is activated by an external trigger and becomes a solid embolic mass upon contact with blood.
Due to the potential drawbacks of traditional liquid embolic agents, such as the difficulty in controlling the degree of polymerization and the need for specialized equipment, there has been a recent focus on developing new liquid embolic agents that overcome these limitations. Some of the advances in this field are:
1. Prepolymerized Liquid Embolic Agents: Prepolymerized liquid embolic agents are being developed to reduce the complexity of the procedure. This type of liquid embolic agent has already been approved for clinical use in Europe. Prepolymerized liquid embolic agents have the potential to reduce procedure time, improve safety, and minimize the need for specialized equipment.
2. Radiopaque Liquid Embolic Agents: Radiopaque liquid embolic agents have improved visualization properties compared to traditional liquid embolic agents. The ability to visualize the embolic material allows for better assessment of the success of the procedure and potential complications.
3. Biocompatible Liquid Embolic Agents: Biocompatible liquid embolic agents are being developed to improve safety and reduce the risk of adverse reactions. These embolic agents have improved biocompatibility properties, reducing the risk of inflammation and other adverse effects.
The potential applications of liquid embolic agents in neurointervention are vast and varied. Some of the most commonly treated conditions using liquid embolic agents are:
1. Arteriovenous Malformations (AVMs): Liquid embolic agents are an effective alternative to surgery for treating AVMs. They have been shown to significantly reduce the size of AVMs and also improve patient outcomes.
2. Aneurysms: Liquid embolic agents are a popular option for treating unruptured aneurysms, particularly in patients who are not good candidates for surgery. They have been shown to reduce the size of aneurysms and prevent rupture.
3. Arteriovenous Fistulas: Liquid embolic agents are commonly used for treating arteriovenous fistulas, a condition in which there is an abnormal connection between an artery and a vein. They have been shown to improve patient outcomes and reduce complications.
Recent progress in liquid embolic agents has resulted in the development of new and improved agents that are safer, more effective, and easier to use. The potential applications of liquid embolic agents in neurointervention are vast and varied, making them a promising alternative to traditional surgical interventions. As this field continues to evolve, we can expect to see further advancements in the liquid embolic agents and an expansion of their applications in neurointervention.