Initial experience with ihtOBTURA ® : A novel EVOH-based embolic agent in the preoperative embolization of hypervascular head,neck,and spinal tumors

Abstract

Background

Preoperative embolization of hypervascular tumors facilitates safer surgical resection by reducing intraoperative bleeding and operative time. ihtOBTURA^® is a novel EVOH-based liquid embolic agent characterized by progressive post-procedural loss of radiopacity due to iodine-based contrast properties. This report presents our initial clinical experience using ihtOBTURA^® for presurgical embolization of hyper vascular tumors.

Methods

We retrospectively reviewed 15 patients (mean age 41.3 years; 9 females) undergoing 16 embolization procedures with ihtOBTURA^® between February and September 2022. Collected data included demographics, lesion pathology and location, arterial feeders, embolization technique, number of pedicles, embolic volume (ml), LEA viscosity, percentage angiographic devascularization, CT artifacts, procedural and technical complications, and surgical outcomes.

Results

Tumor types included meningiomas (n = 9), juvenile nasal angiofibromas (n = 2), carotid body tumors (n = 2), glomus jugulare tumor (n = 1), solitary fibrous tumor (n = 1), and aneurysmal bone cyst (n = 1). Complete (100%) or near-complete (>80%) devascularization was achieved in 80% of patients. The median volume of ihtOBTURA^® used was 4.3 ml (range: 1.0–13.0 ml). Mean procedure time was 90 min (range: 40–176). Surgical resection was completed in 13/14 surgical cases, with a median intraoperative blood loss of 462 ml. No major complications related to the embolization procedures were observed. Excellent penetration and diffusion of the ihtOBTURA^® into the tumor was documented through preoperative imaging and operative pathology samples. Post-embolization imaging showed reduced artifacts.

Conclusion

ihtOBTURA^® is an efficient and safe alternative embolic agent for preoperative tumor devascularization.