Utility of the Amplatzer Vascular Plug in Splenic Artery Embolization: A Comparison Study with Conventional Coil Technique

Journal Article · Wed Jun 15 00:00:00 EDT 2011 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-010-9957-0· OSTI ID:21608677

Xiaoli, Zhu ^[1]; Pierce, Gregory; McLennan, Gordon; Sands, Mark J ^[2]; Lieber, Michael S ^[3]

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1. Suzhou University, Department of Interventional Radiology, First Affiliated Hospital (China)
2. Section of Interventional Radiology, Imaging Institute of Cleveland Clinic (United States)
3. Cleveland Clinic, Department of Quantitative Health Sciences (United States)

Purpose: To retrospectively evaluate the role of the Amplatzer Vascular Plug (AVP) in proximal splenic artery embolization (SAE) compared with coils. Materials and Methods: Forty patients had proximal SAE performed with AVP(s) or coils as the primary embolic agent for splenic artery steal syndrome (n = 23), trauma (n = 5), portal hypertension (n = 5), bleeding due to pancreatic pathology (n = 4), and pre-splenectomy (n = 3). Comparisons were made of occlusion and procedure time, cost, and radiation dose. Results: Eighteen proximal SAE procedures were successfully performed with AVP. Twenty-two procedures were performed with coils, including one failed AVP attempt, which was completed with coils. Precise deployment without migration was achieved in all 18 AVP cases. Seven of 22 (31.8%) coil procedures had distal migration without consequence. There was no statistically significant difference in mean occlusion time (24.4 min for AVP vs. 31.5 min for coils, P = 0.13), procedure time (43.7 min for AVP vs. 53.8 min for coils, P = 0.16), or cost ($1474.13 for AVP vs. $1722.51 for coils, P = 0.69). There was significant difference in radiation dose (842 mGy for AVP vs. 1,309 mGy for coils, P = 0.04). Fourteen of the 18 (78%) AVP devices required additional embolic material. Conclusions: AVP with additional embolic agents is a useful alternative for proximal SAE because of precise deployment, resistance to migration, and radiation reduction. AVP use may be limited by vessel tortuosity. The occlusion time, procedure time, and cost were reduced but this was not statistically significant due to the need for additional embolic material.

• OSTI ID: 21608677
• Journal Information: Cardiovascular and Interventional Radiology, Vol. 34, Issue 3; Conference: CIRSE 2011: Annual meeting of the Cardiovascular and Interventional Radiological Society of Europe, Munich (Germany), 10-14 Sep 2011; Other Information: DOI: 10.1007/s00270-010-9957-0; Copyright (c) 2011 Springer Science+Business Media, LLC and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Country of input: International Atomic Energy Agency (IAEA); ISSN 0174-1551
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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SPLENECTOMY
BLOOD VESSELS
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CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
DIGESTIVE SYSTEM
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