Jambon E, Petitpierre F, Brizzi V, Dubuisson V, Le Bras Y, Grenier N, Cornelis F
Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
Department of Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
Cardiovasc Intervent Radiol. 2017 Feb;40(2):210-215. doi: 10.1007/s00270-016-1480-5. Epub 2016 Dec 5.
To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).
From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10-86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up.
To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess.
The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.
回顾性研究使用Penumbra闭塞装置（POD）对各种中等大小血管（4至8毫米）进行混合近端栓塞的安全性和有效性。
2014年10月至2016年2月，对36例患者（平均年龄：50.8岁，范围：10 - 86岁；男性29例，女性7例）进行了37次使用POD的近端栓塞术。在荧光透视引导下，使用2.7法国微导管实现血管闭塞。在36条目标血管中，16条为脾动脉，11条为肾动脉，4条为肠系膜动脉，3条为动静脉瘘，1条为髂动脉，1条为性腺静脉。进行间歇性随访血管造影以评估最终闭塞的血流情况。通过临床和/或影像学随访评估结果和并发症。
为实现目标血管的近端闭塞，19次栓塞（51.4%）单独使用了POD。在12例手术（32.4%）中，POD用作线圈约束器以固定线圈结构。在6例手术（16.2%）中，在最初部署POD后使用了额外的栓塞装置来实现血管闭塞。平均随访3.2个月后，未观察到POD迁移，但发生了2例并发症（5.4%）：1例栓塞后综合征和1例伴有脾脓肿的广泛梗死。
POD系统在各种临床情况下允许对中等大小血管进行安全有效的近端栓塞。
