PDF(Pubmed)
Abstract：
BACKGROUND: Preemptive selective embolization of aneurysm sac side branches (ASSBs) has been proposed to prevent type II endoleak after endovascular aortic aneurysm repair (EVAR). This study aimed to explore if an embolization strategy using microvascular plugs (MVP) reduces intervention time and radiation dose compared to platinum-fibered microcoils. Furthermore, the effectiveness of the devices in occluding the treated artery was assessed.
METHODS: Sixty patients scheduled for EVAR underwent percutaneous preemptive embolization of ASSBs using MVPs or coils after a 1:1 randomization. Follow-up imaging was performed during aortic stentgraft implantation.
RESULTS: Overall, 170 ASSBs were successfully occluded (83 arteries by MVPs and 87 by coils) and no acute treatment failure occurred. The mean procedure time was significantly lower in the group treated with MVPs (55 ± 4 min) compared to coil occlusion (67 ± 3 min; p = 0.018), which was paralleled by a numerically lower radiation dose (119 Gy/cm2 vs. 140 Gy/cm2; p = 0.45). No difference was found for contrast agent use (34 ml MVP group vs 35 ml coil group; p = 0.87). At follow-up, reopening of lumbar arteries was seen in nine cases (four after coil embolization; five after MVPs).
CONCLUSIONS: Both microvascular plugs and coils can be effectively used for preemptive embolization of aneurysm sac side branches before EVAR. Use of plugs offers a benefit in terms of intervention time.
BACKGROUND: ClinicalTrials.gov Identifier: NCT03842930 Registered 15 February 2019.
METHODS: Sixty patients scheduled for EVAR underwent percutaneous preemptive embolization of ASSBs using MVPs or coils after a 1:1 randomization. Follow-up imaging was performed during aortic stentgraft implantation.
RESULTS: Overall, 170 ASSBs were successfully occluded (83 arteries by MVPs and 87 by coils) and no acute treatment failure occurred. The mean procedure time was significantly lower in the group treated with MVPs (55 ± 4 min) compared to coil occlusion (67 ± 3 min; p = 0.018), which was paralleled by a numerically lower radiation dose (119 Gy/cm2 vs. 140 Gy/cm2; p = 0.45). No difference was found for contrast agent use (34 ml MVP group vs 35 ml coil group; p = 0.87). At follow-up, reopening of lumbar arteries was seen in nine cases (four after coil embolization; five after MVPs).
CONCLUSIONS: Both microvascular plugs and coils can be effectively used for preemptive embolization of aneurysm sac side branches before EVAR. Use of plugs offers a benefit in terms of intervention time.
BACKGROUND: ClinicalTrials.gov Identifier: NCT03842930 Registered 15 February 2019.
摘要：
背景：已提出对动脉瘤囊侧分支（ASSB）进行抢先选择性栓塞以预防血管内主动脉瘤修复（EVAR）后的II型内漏。这项研究旨在探讨与铂纤维微线圈相比，使用微血管塞（MVP）的栓塞策略是否可以减少干预时间和辐射剂量。此外，评估了这些装置闭塞治疗动脉的有效性.
方法：60例计划接受EVAR的患者在1：1随机分组后，使用MVP或线圈对ASSB进行了经皮抢先栓塞。在主动脉支架植入术期间进行随访成像。
结果：总体而言，成功封堵了170个ASSB（MVP封堵了83条动脉，线圈封堵了87条动脉），没有发生急性治疗失败。MVP治疗组的平均手术时间（55±4分钟）明显低于线圈闭塞（67±3分钟；p=0.018），与数值较低的辐射剂量（119Gy/cm2与140Gy/cm2；p=0.45）。对比剂的使用没有差异（34mlMVP组与35ml线圈组；p=0.87）。在后续行动中,9例腰动脉重新开放（线圈栓塞后4例；MVP后5例）。
结论：微血管栓塞和线圈均可有效用于EVAR前动脉瘤囊侧分支的预先栓塞。插头的使用在干预时间方面提供了益处。
背景：ClinicalTrials.gov标识符：NCT03842930于2019年2月15日注册。
方法：60例计划接受EVAR的患者在1：1随机分组后，使用MVP或线圈对ASSB进行了经皮抢先栓塞。在主动脉支架植入术期间进行随访成像。
结果：总体而言，成功封堵了170个ASSB（MVP封堵了83条动脉，线圈封堵了87条动脉），没有发生急性治疗失败。MVP治疗组的平均手术时间（55±4分钟）明显低于线圈闭塞（67±3分钟；p=0.018），与数值较低的辐射剂量（119Gy/cm2与140Gy/cm2；p=0.45）。对比剂的使用没有差异（34mlMVP组与35ml线圈组；p=0.87）。在后续行动中,9例腰动脉重新开放（线圈栓塞后4例；MVP后5例）。
结论：微血管栓塞和线圈均可有效用于EVAR前动脉瘤囊侧分支的预先栓塞。插头的使用在干预时间方面提供了益处。
背景：ClinicalTrials.gov标识符：NCT03842930于2019年2月15日注册。
