Mailli Rémy, Chevallier Olivier, Mazit Amin, Malakhia Alexandre, Falvo Nicolas, Loffroy Romaric
Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, Francois-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France.
ICMUB Laboratory, UMR CNRS 6302, University of Burgundy, 9 Avenue Alain Savary, 21000 Dijon, France.
Biomedicines. 2023 Aug 2;11(8):2172. doi: 10.3390/biomedicines11082172.
The Micro Vascular Plug (MVP, Medtronic) is a mechanical embolic agent available in small sizes that allows for distal embolisation. The objective of this retrospective observational single-centre study was to assess MVP embolisation procedures performed at a university hospital. The 33 patients who underwent MVP embolisation in 2021 were included (mean age, 64; 24 males and 9 females). The primary endpoint was technical success, which was defined as a full first-attempt occlusion with one or more MVPs, as documented on the end-of-procedure angiogram. In all patients, 51 MVPs were used overall, with other embolic agents in 23 of the 33 cases (usually coils and/or glue); 22 of the 33 procedures were emergent for bleeding and 11 were planned for other indications. Of the three technical failures, two were due to an angled target artery configuration precluding microcatheterisation and one to failure of the device to release from its wire. The technical success rate was thus 90.9%. No patient experienced MVP migration or other major complications. Five patients had recurrent clinical symptoms; in four cases, the cause was collateral development, and in one case, the cause was incomplete initial embolisation. No instances of recanalisation were documented during the short follow-up of 12 months, for a 100% secondary clinical success rate. At our tertiary-level centre, the MVP was both effective and safe for peripheral applications. Interventional radiologists should be conversant with the techniques and indications of MVP embolisation.
微血管栓塞栓子（MVP，美敦力公司）是一种尺寸较小的机械性栓塞剂，可用于远端栓塞。这项回顾性单中心观察性研究的目的是评估在一家大学医院进行的MVP栓塞手术。纳入了2021年接受MVP栓塞的33例患者（平均年龄64岁；男性24例，女性9例）。主要终点是技术成功，定义为在手术结束时血管造影记录显示首次尝试使用一个或多个MVP实现完全闭塞。在所有患者中，总共使用了51个MVP，33例中有23例还使用了其他栓塞剂（通常是弹簧圈和/或胶水）；33例手术中有22例因出血而紧急进行，11例因其他指征而计划进行。在3例技术失败中，2例是由于靶动脉呈角状结构，无法进行微导管插入，1例是由于装置无法从导丝上释放。因此，技术成功率为90.9%。没有患者出现MVP移位或其他严重并发症。5例患者出现复发性临床症状；4例是由于侧支循环形成，1例是由于初始栓塞不完全。在12个月的短期随访中未记录到再通情况，二级临床成功率为100%。在我们的三级中心，MVP在外周应用中既有效又安全。介入放射科医生应熟悉MVP栓塞的技术和指征。
