Dimethyl sulfoxide (DMSO) is the solvent carrier used in EVOH-based liquid embolic systems, and its material compatibility with delivery catheters is a foundational procedural consideration. Because DMSO can degrade certain plastics, physicians and procedural staff must confirm that the microcatheter selected for a given case is validated for DMSO-based liquid embolic delivery. This guide reviews the key compatibility and technique factors relevant to interventional teams.
Why Does DMSO Compatibility Matter?
DMSO is a highly effective solvent for ethylene vinyl alcohol (EVOH) copolymer, which is what allows liquid embolic agents like LIBRO to remain in a flowable liquid state until injected. However, DMSO's solvent properties are not limited to EVOH—it can also interact with and degrade certain catheter hub materials, adhesives, and polymer shafts that are not specifically rated for DMSO exposure.
Using an incompatible catheter can compromise catheter integrity during injection, potentially affecting procedural safety and device performance. This is why every liquid embolic product's Instructions for Use (IFU) specifies which catheter characteristics are required or recommended.
What Should Be Confirmed Before Selecting a Microcatheter?
Interventional teams typically verify several factors before a liquid embolic case:
- DMSO-rated hub and shaft materials: confirm the microcatheter manufacturer states DMSO compatibility for the intended dwell time.
- Internal lumen coating: some catheters use coatings designed to reduce friction during viscous liquid embolic injection.
- Dead space volume: understanding the catheter's internal dead space helps the physician calculate appropriate DMSO flush volume before embolic injection, since inadequate flushing can lead to premature precipitation within the catheter.
- Compatible microcatheter family: INVAMED's MicroCATH neurovascular catheter family is designed to support delivery of embolic materials, including liquid agents and coils, in neurovascular and peripheral interventions.
How Does Injection Technique Relate to Catheter Selection?
Because EVOH-based liquid embolics precipitate through a solvent-exchange mechanism, injection technique and catheter selection are closely linked. A catheter with excessive dead space may require a larger DMSO flush volume, while a catheter with poor pushability in tortuous anatomy may complicate achieving and maintaining wedged catheter position during a slow, controlled injection.
Physicians generally aim to advance the microcatheter as close to the target lesion as anatomically feasible, confirm catheter tip position under imaging, and follow the specific priming and injection protocol described in the product IFU.
What Are the Broader Procedural Considerations?
Beyond catheter compatibility, physicians weigh vessel anatomy, flow dynamics, and lesion characteristics when planning a liquid embolic procedure. All embolization procedures carry inherent risks, including the possibility of non-target embolization, and technique and device selection should always be guided by the treating physician's clinical judgment and the applicable product labeling.
Frequently Asked Questions
What happens if a non-DMSO-compatible catheter is used?
Using a catheter not rated for DMSO exposure may risk degradation of catheter materials during the procedure, which could compromise device integrity. Physicians should always confirm compatibility against the liquid embolic agent's IFU before catheter selection.
Why is dead space volume important in liquid embolic delivery?
The catheter's dead space must be adequately flushed with DMSO before embolic injection to prevent the EVOH copolymer from precipitating prematurely within the catheter lumen, which could obstruct the catheter or affect embolic delivery.
Are all microcatheters interchangeable for liquid embolic use?
No. Microcatheter selection should be based on documented DMSO compatibility, appropriate lumen diameter, and navigability suited to the target anatomy. The treating physician determines the appropriate device combination for each case.
Related INVAMED Resources
- MicroCATH Neurovascular Catheter Family
- LIBRO Non-Adhesive Embolization Agent
- Embolization Products at INVAMED
Medical Disclaimer: This article is provided for general informational and educational purposes only and does not constitute medical advice, diagnosis, or treatment recommendation. It is not a substitute for consultation with a qualified healthcare professional. Product indications, availability, and regulatory status vary by country. Always refer to the official Instructions for Use (IFU) and consult a licensed physician for guidance specific to your situation. INVAMED devices are intended for use by trained healthcare professionals.