Aims and objectives
Endovascular embolizations are procedures representingpart of the daily practice in all Interventional RadiologyDepartments.
Multiple embolizing agents are available; they can be grouped in three categories: particles,
liquids and metallicdevices.
The choice depends usually on three elements: vascularpathology,
arterial anatomy,
and operator preference.
Vascular plugs are definitive metallic devices applied for occluding arterial vessels; recently,
a new detachable microvascularplug (MVP,
Reverse Medical,
Irivine,
CA,
USA) has been developed.
This series describes an initial single-center experienceon ten patients examining intraprocedural safety and technicalsuccess of MVP for embolization...
Methods and materials
In the last two years,
ten patients have been treated forarterial embolization using MVP: 6 males and 4 women,
andmean age 55.1 years (range 20–80 years).
The MVP is a self-expanding device composed of a detachableovoid-shaped embolic plug; the skeleton is made ofNitinol and it is covered with a Polytetrafluoroethylene(PTFE) coating (Fig.
1).
At moment,
three sizes are available (Table 1): 3,
5 and 7; MVP3 and MVP5 are released through a 2.7 Fr microcath while MVP7 is released through a 4 Fr catheter.
All...
Results
In all cases,
the MVP was successfully releasedin < 1 min.
In 8patients,
the MVP was adopted in extracranialarterial vessels,
while in 2 cases,
the carotid syphon wasembolized (Table 2).
The clinical scenarios were: 4 active bleedings (Fig.
2 and 3),
2 iatrogenic pseudoaneurysms (Fig.
4 and 5),
1 preoperative vessel occlusion,
3 true aneurysms.
In 6 patients,
the MVP was the primary and sole embolizingagent employed; in 4subjects,
the MVP was positionedcomplementary after coils to definitely seal the target arteryjust proximally to the lesion....
Conclusion
The MVP seems to combine the efficacy of AMPLATZERplug with the navigability of micro-coils,
being able toreach distal targets thanks to the microcatheter delivery; thevascular flow should stop immediately if the correct MVP caliper has been choosen,
since it is a partiallyPTFE covered device.
Based on the reported experience,
the mainadvantage is related to MVP3 and MVP5 models that canbe adopted for distal embolization thanks to the preciserelease through 0.027″ microcatheter.
The pros of the MVP are:the device is able to easily navigate in tortuous...
Personal information
Francesco Giurazza,
MD - PhD
Interventional Radiology Dept.
Cardarelli Hospital
Via A.
Cardarelli 9,
80100,
Naples,
Italy
[email protected]
References
Giurazza F,
Corvino F,
Cavaglià E et al.
Arterial embolizations with microvascular plug in extracranialand intracranial districts: technical results.
Radiol Med 2017 DOI 10.1007/s11547-017-0831-x
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Microvascular plug: anew embolic material for hepatic arterial skeletonization.
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https://doi.org/10.1007/s00270-014-0889-y
Kleine JF,
Prothmann S,
Boeckh-Behrens T.
Occlusion ofsmall arteries in the neuroendovascular and head and neck territory-initial experiences with a microvascular plug.
J Vasc Interv Radiol 2015 26(3):426-31
Sathanandam S,
Justino H,
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The MedtronicMicro Vascular Plug™ for...