Selective occlusion of splenic artery aneurysms with the coil packing technique: the impact of packing density on aneurysm reperfusion correlated between contrast-enhanced MR angiography and digital subtraction angiography
| Autor: | Edyta Maj, Krzysztof Milczarek, Olgierd Rowiński, Thomas Rix, Krzysztof Korzeniowski, Rafał Maciąg, Krzysztof Lamparski, Tomasz Ostrowski, Emilia Wnuk, Mikołaj Wojtaszek |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_treatment Contrast Media Splenic artery Magnetic resonance angiography 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.artery Occlusion medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Embolization Aged Retrospective Studies Neuroradiology medicine.diagnostic_test business.industry Angiography Digital Subtraction Interventional radiology General Medicine Digital subtraction angiography Middle Aged medicine.disease Embolization Therapeutic Treatment Outcome 030220 oncology & carcinogenesis cardiovascular system Female Stents Nuclear medicine business Splenic Artery Magnetic Resonance Angiography |
| Zdroj: | La radiologia medica. 124:450-459 |
| ISSN: | 1826-6983 0033-8362 |
| DOI: | 10.1007/s11547-019-00993-2 |
| Popis: | 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. 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. 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. 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 IV, therapeutic study. |
| Databáze: | OpenAIRE |
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