Yunaiyama Daisuke, Saguchi Toru, Moriya Tomohisa, Shirota Natsuhiko, Otaka Jun, Tokuuye Koichi, Nagakawa Yuichi, Tsuchida Akihiko, Saito Kazuhiro
Department of Radiology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, Japan.
Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Cardiovasc Intervent Radiol. 2017 Aug;40(8):1255-1260. doi: 10.1007/s00270-017-1589-1. Epub 2017 Feb 8.
To evaluate the feasibility of short-segment coil embolization between 2 balloons for tight packing in an experimental vascular model.
Three coil embolization techniques were performed by 5 interventional radiologists as follows: (1) proximal balloon technique (proximal BT) which involved proximal balloon inflation and coil deployment over the balloon, (2) distal balloon technique (distal BT) which involved distal balloon inflation and coil deployment at the proximal side of the inflated balloon, and (3) double-balloon technique (DBT) which involved coil deployment between 2 inflated balloons. We used a 10-mm-diameter and 200-mm-long hydrocoil. The distance between the 2 inflated balloons was set at 5 mm in the perfused tube, and each procedure was performed twice. The longitudinal lengths of the deployed coil mass and volume embolization rates (VERs) at the embolization site obtained using the 3 techniques were compared statistically.
The longitudinal lengths of the deployed coil mass were 26 mm (range, 21-34 mm), 10 mm (8-14 mm), and 5 mm (5-5 mm) in proximal BT, distal BT, and DBT, respectively. The median VERs were 15.9% (12.2-19.4%), 41.4% (29.6-51.8%), and 82.9% (82.9-82.9%), respectively. Significant differences in the lengths and VERs were observed among the 3 techniques (p < 0.001).
DBT achieved the tight packing of a hydrocoil in a short segment of an experimental vascular model compared with proximal BT and distal BT, suggesting DBT as the optimal embolization technique in this model.
在实验性血管模型中评估在两个球囊之间进行短节段线圈栓塞以实现紧密填塞的可行性。
5名介入放射科医生进行了三种线圈栓塞技术，具体如下：（1）近端球囊技术（近端BT），包括近端球囊充气并在球囊上方部署线圈；（2）远端球囊技术（远端BT），包括远端球囊充气并在充气球囊的近端部署线圈；（3）双球囊技术（DBT），包括在两个充气球囊之间部署线圈。我们使用了直径10毫米、长200毫米的水凝胶线圈。在灌注管中将两个充气球囊之间的距离设定为5毫米，每个操作重复进行两次。对使用这三种技术在栓塞部位获得的展开线圈团块的纵向长度和体积栓塞率（VERs）进行统计学比较。
近端BT、远端BT和DBT中展开线圈团块的纵向长度分别为26毫米（范围21 - 34毫米）、10毫米（8 - 14毫米）和5毫米（5 - 5毫米）。VERs的中位数分别为15.9%（12.2 - 19.4%）、41.4%（29.6 - 51.8%）和82.9%（82.9 - 82.9%）。三种技术在长度和VERs方面观察到显著差异（p < 0.001）。
与近端BT和远端BT相比，DBT在实验性血管模型的短节段中实现了水凝胶线圈的紧密填塞，表明DBT是该模型中的最佳栓塞技术。
