Fig 1.

Representative embolization procedure with PHIL 25% LV. A, Before the embolization procedure, a diagnostic angiography is performed through a guiding catheter. The RM is delineated in the diagnostic angiography image with complete filling of the RM. B, X-ray after the first injection. After the first injection, most of the RM is already embolized. The injection is stopped because of embolization distal to the RM (arrow). C, X-ray after the second injection. The second injection leads to slight additional filling of the lateral parts of the RM (black arrow). The injection is stopped because of reflux (arrowhead). Retrospectively, this is the injection with which the maximal embolization extent was reached. Accordingly, the reflux distance is measured in this image (double arrow). X-rays after the fifth (D) and eighth (E) injections. No more filling of the RM is achieved with the following injections, which were all stopped because of reflux (arrowheads). After the eighth injection, the procedure is terminated because of reflux of the LEA into the APA (arrow). F, After termination of the procedure, the catheters are removed and the embolized portion of the RM is delineated. The area of the completely filled RM (A) and the area of the embolized RM (F) are related, resulting in the embolization extent.