Yoshiaki Katada1, Shiro Onozawa2, Shoichi Takahashi3, Shigeru Suzuki1. 1. 1 Department of Radiology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan. 2. 2 Department of Radiology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan. 3. 3 Department of Cardiovascular Surgery, Hoshi General Hospital, Fukushima, Japan.
Abstract
PURPOSE: To report an experimental study and clinical case using a coil packing technique that hastens occlusion of an Amplatzer Vascular Plug 1 (AVP1) in short-segment embolization of high-flow target vessels. TECHNIQUE: An experimental vascular stenosis model was made of 12-mm soft polyvinyl chloride tubing. Under continuous pulsatile flow, a 12-mm AVP1 was deployed in the 4-mm-diameter stenosis. Before detachment of the AVP1, a 2.2-F microcatheter was inserted into the AVP1 through its mesh via a 6-F delivery guiding sheath in parallel with the delivery wire. Hydrogel microcoils were deployed tightly in the AVP1 and the plug was detached. After the procedure, the pulsatile saline flow was nearly obliterated. In the first clinical case, a 64-year-old man with a thoracic aortic stent-graft and single vessel debranching for type B aortic dissection developed a residual type II endoleak via the left subclavian artery. This coil packing technique in an AVP1 was employed to successfully embolize the leak. CONCLUSION: Based on the experimental study and the first experience in vivo, tight coil packing of an AVP1 might be a robust technique for ultrashort-segment embolization.
PURPOSE: To report an experimental study and clinical case using a coil packing technique that hastens occlusion of an Amplatzer Vascular Plug 1 (AVP1) in short-segment embolization of high-flow target vessels. TECHNIQUE: An experimental vascular stenosis model was made of 12-mm soft polyvinyl chloride tubing. Under continuous pulsatile flow, a 12-mm AVP1 was deployed in the 4-mm-diameter stenosis. Before detachment of the AVP1, a 2.2-F microcatheter was inserted into the AVP1 through its mesh via a 6-F delivery guiding sheath in parallel with the delivery wire. Hydrogel microcoils were deployed tightly in the AVP1 and the plug was detached. After the procedure, the pulsatile saline flow was nearly obliterated. In the first clinical case, a 64-year-old man with a thoracic aortic stent-graft and single vessel debranching for type B aortic dissection developed a residual type II endoleak via the left subclavian artery. This coil packing technique in an AVP1 was employed to successfully embolize the leak. CONCLUSION: Based on the experimental study and the first experience in vivo, tight coil packing of an AVP1 might be a robust technique for ultrashort-segment embolization.