REGULAR CONTENT
Final ID
504
Type
Original Scientific Research-Oral or Pos
Authors
A Lee1, J Kessler2, J Park3
Institutions
1CITY OF HOPE MEDICAL CENTER, Duarte, CA, 2City of Hope National Medical Center, Duarte, CA, 3City of Hope Medical Center, Duarte, CA
Purpose
Pre-Y90 radioembolization mapping angiography is a critical step to insure the safety of the procedure. Traditionally, prophylactic embolization of non-target vessels such as the gastroduodenal artery(GDA) has been performed using coils. This study reviews our initial experiences using microvascular plugs(MVP) suitable for the occlusion of 3-5 mm diameter vessels via a microcatheter delivery system for protective embolization of the GDA prior to Y90 therapy.
Materials & Methods
A total of 34 patients had prophylactic embolization of the GDA performed between October 2014 and March 2016 using the MVP plug(Medtronic; Minneapolis, MN). A single MVP-3Q or MVP 5Q plug(suitable for occlusion of 3-5 mm vessels) was deployed per patient depending on vessel size. The mean patient age was 61.7 years(±14.3 years). The study included 24 males and 10 females. The most common tumor types were colon cancer(n = 14) and hepatocellular carcinoma(n = 9). Followup angiography was performed during Y90 administration to evaluate the safety and efficacy of plug embolization.
Results
In all cases, there was immediate initial intraprocedural imaging evidence of vascular occlusion. A single MVP plug was deployed per patient. In two cases, additional coil embolization was performed during mapping angiography due to distal migration of the plug. In two other cases, a single detachable framing coil was deployed prior to plug embolization during mapping angiography at the discretion of the performing interventional radiologist. The mean time from mapping angiography to Y90 administration was 13.1 days (±9.6 days). On followup angiography, there was only one case of GDA recanalization requiring further coil embolization. There were no cases of delayed vascular plug migration. Planned radiotherapy was performed in all patients on day of intended treatment.
Conclusions
With the introduction of microvascular plugs that can be deployed via a microcatheter, the potential applications of these devices have expanded. In this study, we report our experiences using the MVP plug for pre-Y90 prophylactic embolization of the GDA in 34 patients. In our series, the MVP plug was safe, effective, and stable for hepatic arterial skeletonization.
Final ID
504
Type
Original Scientific Research-Oral or Pos
Authors
A Lee1, J Kessler2, J Park3
Institutions
1CITY OF HOPE MEDICAL CENTER, Duarte, CA, 2City of Hope National Medical Center, Duarte, CA, 3City of Hope Medical Center, Duarte, CA
Purpose
Pre-Y90 radioembolization mapping angiography is a critical step to insure the safety of the procedure. Traditionally, prophylactic embolization of non-target vessels such as the gastroduodenal artery(GDA) has been performed using coils. This study reviews our initial experiences using microvascular plugs(MVP) suitable for the occlusion of 3-5 mm diameter vessels via a microcatheter delivery system for protective embolization of the GDA prior to Y90 therapy.
Materials & Methods
A total of 34 patients had prophylactic embolization of the GDA performed between October 2014 and March 2016 using the MVP plug(Medtronic; Minneapolis, MN). A single MVP-3Q or MVP 5Q plug(suitable for occlusion of 3-5 mm vessels) was deployed per patient depending on vessel size. The mean patient age was 61.7 years(±14.3 years). The study included 24 males and 10 females. The most common tumor types were colon cancer(n = 14) and hepatocellular carcinoma(n = 9). Followup angiography was performed during Y90 administration to evaluate the safety and efficacy of plug embolization.
Results
In all cases, there was immediate initial intraprocedural imaging evidence of vascular occlusion. A single MVP plug was deployed per patient. In two cases, additional coil embolization was performed during mapping angiography due to distal migration of the plug. In two other cases, a single detachable framing coil was deployed prior to plug embolization during mapping angiography at the discretion of the performing interventional radiologist. The mean time from mapping angiography to Y90 administration was 13.1 days (±9.6 days). On followup angiography, there was only one case of GDA recanalization requiring further coil embolization. There were no cases of delayed vascular plug migration. Planned radiotherapy was performed in all patients on day of intended treatment.
Conclusions
With the introduction of microvascular plugs that can be deployed via a microcatheter, the potential applications of these devices have expanded. In this study, we report our experiences using the MVP plug for pre-Y90 prophylactic embolization of the GDA in 34 patients. In our series, the MVP plug was safe, effective, and stable for hepatic arterial skeletonization.