BackTable Vascular & Interventional Ep. 549 Liquid Embolics: Practical Applications and Techniques with Dr. Gary Siskin
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Jun 3, 2025 Dr. Gary Siskin, Chair of Radiology at Albany Medical Center and an expert in liquid embolic agents, shares valuable insights into their practical applications. He discusses techniques for the effective use of Onyx and LAVA in complex cases, especially in trauma care. Key topics include managing catheter positioning and preventing reflux with tailored injection speeds. Siskin emphasizes the importance of understanding viscosity differences and minimizing complications during procedures, making it a must-listen for interventional radiologists seeking to enhance their skills.
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Educate Before Using Liquids
- New users should choose safe vascular beds and get proper education before using liquid embolics.
- Different products have varied viscosities and injection nuances that must be understood for safe use.
Liquid Embolics Improve Packing Density
- Liquid embolics provide much higher packing density than coils, filling over 90% of target volume versus coils' 24-40%.
- This makes liquids superior for fully filling aneurysms or spaces where clot formation is unreliable.
Use Liquids in Coagulopathic Patients
- Use liquid embolics to fill spaces where clotting is poor or coagulopathy is present, as liquids don't rely on clot formation.
- Liquids fill spaces and gaps that coils cannot, providing reliable occlusion even in challenging patients.