Mikołaj Wojtaszek1,2, Krzysztof Lamparski3, Emilia Wnuk3, Tomasz Ostrowski4, Rafał Maciąg3, Thomas Rix5, Edyta Maj3, Krzysztof Milczarek3, Krzysztof Korzeniowski3, Olgierd Rowiński3. 1. 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland. nwojtaszek@gmail.com. 2. Vascular Unit, Kent & Canterbury Hospital, East Kent Hospital University NHS Trust, Canterbury, Kent, CT1 3NG, UK. nwojtaszek@gmail.com. 3. 2nd Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland. 4. Department of General and Endocrine Surgery, Medical University of Warsaw, Banacha 1a Street, 02-097, Warsaw, Poland. 5. Vascular Unit, Kent & Canterbury Hospital, East Kent Hospital University NHS Trust, Canterbury, Kent, CT1 3NG, UK.
Abstract
PURPOSE: The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA. MATERIALS AND METHODS: Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated. RESULTS: Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method. CONCLUSION: Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction. LEVEL OF EVIDENCE: Level IV, therapeutic study.
PURPOSE: The aim was to evaluate the relationship between coil packing densities after splenic artery aneurysm (SAA) treatment using detachable microcoils and rates of SAA reperfusion and to suggest a post-treatment surveillance protocol using contrast-enhanced MRA. MATERIALS AND METHODS: Evaluated were 16 patients (4 men; mean age 46.7), who underwent true SAA embolization using detachable microcoils (Concerto, Medtronic). SAAs were treated by selective coil packing (CP) or stent-assisted coil exclusion (SAC). Contrast-enhanced magnetic resonance angiography (CE-MRA) and digital subtraction angiography (DSA) were performed at 3 months post-procedure and correlated. RESULTS: Primary CP was used in 13 patients, while SAC was used in three patients. On follow-up, complete aneurysm occlusion was seen in seven patients (43.8%). Sac reperfusion occurred in nine patients (56.2%) and was demonstrated in all CE-MRA and six DSA studies. Mean aneurysm packing density was 20.10 ± 8.05% for the CP group and 32.90 ± 11.95% for the SAC group (p = 0.038). There was a significant difference in the incidence of aneurysm sac reperfusion on CE-MRA study between CP and SAC (9 vs. 0). No sac reperfusion was seen in aneurysms with packing densities ≥ 29%, irrespective of either embolization method. CONCLUSION: Favorable midterm results for coil packing of SAAs seem to depend on the coil packing density with a coil volume approximately a quarter of the aneurysm volume being most effective. Follow-up should involve the use of CE-MRA as this modality has been shown to be superior over DSA in detecting aneurysm reperfusion and coil compaction. LEVEL OF EVIDENCE: Level IV, therapeutic study.
Authors: Alan T Hirsch; Ziv J Haskal; Norman R Hertzer; Curtis W Bakal; Mark A Creager; Jonathan L Halperin; Loren F Hiratzka; William R C Murphy; Jeffrey W Olin; Jules B Puschett; Kenneth A Rosenfield; David Sacks; James C Stanley; Lloyd M Taylor; Christopher J White; John White; Rodney A White; Elliot M Antman; Sidney C Smith; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Raymond J Gibbons; Sharon A Hunt; Alice K Jacobs; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: J Vasc Interv Radiol Date: 2006-09 Impact factor: 3.464
Authors: Jung Min Seo; Kwang Bo Park; Keon Ha Kim; Pyoung Jeon; Sung Wook Shin; Hong Suk Park; Young Soo Do; Dong-Ik Kim; Young-Wook Kim Journal: Acta Radiol Date: 2011-08-12 Impact factor: 1.990
Authors: R Guillon; J M Garcier; A Abergel; R Mofid; V Garcia; T Chahid; A Ravel; D Pezet; L Boyer Journal: Cardiovasc Intervent Radiol Date: 2003 May-Jun Impact factor: 2.740
Authors: Daniel G Soliński; Marcin Celer; Krzysztof Dyś; Maciej Wiewióra Journal: Wideochir Inne Tech Maloinwazyjne Date: 2021-07-13 Impact factor: 1.195
Authors: Vincenza Granata; Roberta Fusco; Simona Salati; Antonella Petrillo; Elio Di Bernardo; Roberta Grassi; Raffaele Palaia; Ginevra Danti; Michelearcangelo La Porta; Matteo Cadossi; Gorana Gašljević; Gregor Sersa; Francesco Izzo Journal: Int J Environ Res Public Health Date: 2021-05-24 Impact factor: 3.390