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Treatment of Dural Arteriovenous Fistulas With SQUID™ Liquid Embolic Agent

Completed
Conditions
Dural Arteriovenous Fistula
Interventions
Device: Squid
Registration Number
NCT03524976
Lead Sponsor
Dr. Markus Alfred Möhlenbruch
Brief Summary

The purpose of this study is assessment of safety, efficacy, and short-term outcome of SQUID™ in the embolization of Dural Arteriovenous Fistula

Detailed Description

Traditionally, there are two therapeutic options for the treatment of Dural Arteriovenous Fistula (DAVF): (1) the surgical approach consisting of craniotomy and ligation of the vein and (2) the endovascular approach with embolization of shunting zone. Onyx™ (EVOH (Ethylene Vinyl Alcohol) in solution in an organic solvent, DMSO (Dimethyl Sulfoxide), is the main embolic agent used for the endovascular treatment of DAVF. During the occlusion procedure with Onyx™, residual malformed compartments become gradually less visible on x-ray to the operator, due to the high radiopacity of Onyx™, resulting in a potential risk during treatment. Moreover, viscosity is frequently not as low as required to penetrate the shunt.Thus, development a new embolization system with lower radiopacity and lower viscosity to achieve improved occlusion is needed. SQUID™ is a new liquid embolic agent, with variable radiopacity and viscosity. The purpose of this study is assessment of safety, efficacy, and short-term outcome of SQUID™ in the embolization of DAVFs .

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Dural Arteriovenous Fistula requiring endovascular treatment with a Lariboisiere score between 3 - 5

    • Intended usage of SQUID™
    • The patient agrees with the clinical data collection and medical file access.
Exclusion Criteria
  • DAVF with a Lariboisiere score < 3 • Pregnancy

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Embolization with SquidSquidAll patients with DAVFs are treated with SQUID™ aiming at complete occlusion of the fistula. Each participating center will include patients with DAVFs in whom the liquid embolic agent SQUID™ is planned to be used consecutively in the study. The
Primary Outcome Measures
NameTimeMethod
Morbidity/Mortality90-180 days after treatment

number of patients with permanent morbidity or mortality

Occlusion rate90 -180 days after treatment

number of patients with complete occlusion of the treated Dural Arteriovenous Fistula

Secondary Outcome Measures
NameTimeMethod
Follow-Up Aneurysm Occlusion90-180 days after treatment

1. 50-99% occlusion

2. \< 50% occlusion

Functional health status90-180 days after treatment

based on modified Rankin Scale

FeedersTreatment / day 1

number of feeders embolized,

DAVF anatomyBaseline / day 0-1

Anatomical description of the Dural Arteriovenous Fistula using Lariboisiere classification

modified Rankin ScoreBaseline / day 0-1

Baseline mRS

ApproachTreatment / day 1

approach path (vessel)

Volume of SquidTreatment / day 1

volume and concentration of SQUID™ injected at each embolization

BallonsTreatment / day 1

Binary: for access to DAVF was a balloon catheter used / no balloon used

CoilsTreatment / day 1

If complete occlusion was not achieved using Squid: Binary Outcome: use of coils or no use of coils

OtherTreatment / day 1

If complete occlusion was not achieved using Squid: Binary Outcome: use of other embolization agent / no other agent used

Immediate Aneurysm OcclusionTreatment / Day 1

1. 50-99% occlusion

2. \< 50% occlusion

Trial Locations

Locations (7)

Klnikum Augsburg

🇩🇪

Augsburg, Germany

Alfried Krupp Krankenhaus Rüttenscheid

🇩🇪

Essen, Germany

University Clinic Bochum

🇩🇪

Bochum, Germany

LMU Klinikum der Universität München

🇩🇪

München, Germany

Klinische und interventionelle Neuroradiologie Vivantes Klinikum Neukölln

🇩🇪

Berlin, Germany

Klinik für Neuroradiologie Universitätsklinikum Freiburg

🇩🇪

Freiburg, Germany

Charité-Universitätsmedizin Berlin

🇩🇪

Berlin, Germany

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