Efficacy and safety of the PHIL embolic agent in the treatment of intracranial dural arteriovenous fistulas - results of the PHIL-dAVF study

Sep 29, 2026

Uploaded by jayni

Embolization is the first-line treatment for intracranial dural arteriovenous fistulas, and the precipitating hydrophobic injectable liquid (PHIL) is a non-adhesive polymer developed for specific endovascular behavior. The PHIL-dAVF study evaluated PHIL safety and efficacy in a prospective real-life cohort. In a prospective single-arm multicenter design, functional outcomes and complete cure at 3–6 months were assessed, with adverse events as the primary safety measure.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Abstract

Background and Purpose

Methods

Results

Conclusion

Introduction

What is already known on this topic

What this study adds

How this study might affect research, practice or policy

New devices and techniques Original research Efficacy and safety of the PHIL embolic agent in the treatment of intracranial dural arteriovenous fistulas: results of the PHIL-dAVF study Gaultier Marnat , 1 Xavier Barreau, 1 Anne-Christine Januel,2 Laurent Spelle ,3,4 Michel Piotin,5 Charbel Mounayer,6 Ljubisa Borota,7 Alejandro González,8 Alfredo Casasco ,9,10 Peter Keston, 11 Kyriakos Lobotesis , 12 Mats Cronqvist, 13 Markus Holtmannspötter, 14 Leopoldo Guimaraens, 15 Edoardo Boccardi, 16 Luca Valvassori , 17 Mariano Espinosa de Rueda , 18 Christophe Cognard , 19 on behalf of the PHIL-dAVF study investigators ► Additional supplemental material is published online only. To view, please visit the journal online ([https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.1136/jnis-2024-022630](10.1136/jnis-2024-022630)) . For numbered affiliations see end of article. Correspondence to Dr Gaultier Marnat; gaultier. [marnat@chu-bordeaux.fr](marnat@chu-bordeaux.fr) Received 15 October 2024 Accepted 18 December 2024 © Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. To cite: Marnat G, Barreau X, Januel A-C, et al. J NeuroIntervent Surg Epub ahead of print: [please include Day Month Year] . doi:10 . 1136/jnis-2024- 022630 ABSTRACT Background and Purpose Embolization is the firstline treatment for dural arteriovenous fistulas (dAVF) . The precipitating hydrophobic injectable liquid (PHIL) embolicagent is a non-adhesive copolymer with specific features and endovascular behavior. This study assessed its safety and efficacy in a prospective real-life cohort. Methods The PHIL-dAVF study was a prospective single-arm open-label observational multicenter study conducted between October 2017 and November 2019 in 14 European centers. Patients with a single intracranial dAVF intended for PHIL embolization were included. Previously partially treated or multiple dAVFs were excluded. Additional devices and embolic agents were permitted as complementary techniques or second-line strategies. Primary endpoints were functional outcome changes from baseline and complete cure rate at 3–6 months after the last embolization. Safety was assessed by adverse events (AE) incidence. Results A total of 67 patients (77 endovascular procedures; 70 . 1% men, mean age 61±14 years) were included. Most DAVFs were unruptured (71 .6%), located in the transverse/sigmoid sinus (53 . 7%) and Cognard grade III or IV (56 . 7%) . Sixty patients (89 .6%) received one single embolization. Additional devices were used in 31. 2% of procedures. Complete angiographic cure rate was 86.9% at the 3–6 month DSA follow-up after the last endovascular treatment. At least one AE was recorded in 37 . 3% of patients during follow-up, of which 52.9% were related to the procedure. The procedural rates of AE and serious AE were 32. 5% and 15.6%, respectively. Five AEs were related to PHIL. Transient functional deterioration occurred in three patients (4 . 5%), all resolved by the last follow-up. Conclusion The PHIL-dAVF study provides evidence about the efficacy and safety of PHIL in the treatment of intracranial dAVFs, with outcomes comparable to existing liquid embolic agents reported in the literature. INTRODUCTION Intracranial dural arteriovenous fistulas (dAVFs) are acquired arteriovenous shunts with a wide spectrum of clinical presentation, such as intracranial WHAT IS ALREADY KNOWN ON THIS TOPIC | ⇒ Embolization is the first-line treatment for dural arteriovenous fistulas (dAVFs) .
⇒ Available liquid embolic agents are effective, but may have various technical, efficacy, and safety profiles.
⇒ Precipitating hydrophobic injectable liquid (PHIL) is a recently developed non-adhesive embolic agent, offering singular physical and chemical properties compared with alternative embolic agents.
WHAT THIS STUDY ADDS | | --- | | ⇒ This prospecti

FAQs

What was the PHIL-dAVF study designed to assess?

It assessed the safety and efficacy of the PHIL embolic agent for treating intracranial dural arteriovenous fistulas in a prospective real-life cohort.

Who was included and who was excluded in the study?

Patients with a single intracranial dAVF intended for PHIL embolization were included, while previously partially treated cases or patients with multiple dAVFs were excluded.

What were the main findings on efficacy and safety?

The study reported an angiographic cure rate of 86.9% at 3–6 months after the last treatment, and at least one adverse event occurred in 37.3% of patients, with procedure-related events reported in 52.9% of those.

Sep 29, 2026

Uploaded by jayni