Department of Radiology, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504, Japan.
Jpn J Radiol. 2013 Mar;31(3):215-9. doi: 10.1007/s11604-012-0167-3. Epub 2013 Jan 12.
Celiac trunk coil embolization before thoracic endovascular aneurysm repair (TEVAR) of a thoracoabdominal aortic aneurysm involving the celiac trunk can prevent type II endoleaks. One disadvantage of conventional coil embolization is the risk of coil displacement. We performed coil embolization under balloon occlusion of the celiac trunk to address this issue.
Between December 2008 and January 2011, 5 patients (3 men and 2 women, mean age 76 years) were included in this study. For all patients, after confirming the collateral blood flow from the superior mesenteric artery via the pancreaticoduodenal arcades by using the balloon occlusion test, celiac trunk coil embolization proceeded under balloon occlusion of the proximal part of the celiac trunk.
Balloon-assisted coil embolization of the celiac trunk was completed for all patients without any complications. All coils were deployed as planned in the short segment of the celiac trunk without displacement. Coil migration, ischemic complications, and endoleaks via the celiac trunk did not arise in any of the patients over a follow-up period of 77-637 (mean 258) days.
Balloon-assisted coil embolization of the celiac trunk before TEVAR could be a feasible treatment option for suitable patients.
在胸主动脉瘤腔内修复术(TEVAR)前对累及腹腔干的胸腹主动脉瘤进行腹腔干线圈栓塞,可以预防 II 型内漏的发生。传统线圈栓塞的一个缺点是线圈移位的风险。我们通过腹腔干球囊阻断来进行线圈栓塞以解决这个问题。
在 2008 年 12 月至 2011 年 1 月期间,我们纳入了 5 名患者(3 名男性和 2 名女性,平均年龄 76 岁)进行了本研究。对于所有患者,在通过球囊闭塞试验确认了来自肠系膜上动脉的侧支血流通过胰十二指肠弓后,在腹腔干近端进行球囊阻断的情况下进行腹腔干线圈栓塞。
所有患者均成功地完成了球囊辅助的腹腔干线圈栓塞,没有出现任何并发症。所有的线圈都按照计划部署在腹腔干的短段内,没有发生移位。在 77-637 天(平均 258 天)的随访期间,没有患者出现线圈迁移、缺血性并发症或通过腹腔干发生内漏。
在 TEVAR 前进行球囊辅助的腹腔干线圈栓塞可能是适合患者的一种可行的治疗选择。