Deguchi Masae, Sonomura Tetsuo, Sato Hirotatsu, Kamisako Atsufumi, Kakimoto Nobuyuki, Suzuki Takayuki, Suenaga Tomohiro, Takeuchi Takashi, Suzuki Hiroyuki, Tokuhara Daisuke, Fukuda Kodai, Higashino Nobuyuki, Ikoma Akira, Minamiguchi Hiroki
Department of Radiology, Wakayama Medical University, Japan.
Department of Pediatrics, Wakayama Medical University, Japan.
Interv Radiol (Higashimatsuyama). 2025 Jul 23;10:e20240051. doi: 10.22575/interventionalradiology.2024-0051. eCollection 2025.
We retrospectively analyzed the effect of coil type on the number of coils used and the procedure time in pre-Fontan coil embolization of collateral arteries.
Twelve patients with congenital heart disease underwent coil embolization before Fontan surgery between 2010 and 2021. They were divided into 2 groups. Group A comprised 6 patients who underwent coil embolization before the introduction of longer microcoils (≥30 cm) and group B comprised 6 patients who underwent embolization after the introduction of the microcoils. The primary endpoints (number of coils used, embolized area per patient and the internal thoracic artery, and procedure time) were compared between the 2 groups.
The number of coils used per patient and internal thoracic artery (groups A vs. B: 36.5 vs. 18; p = 0.036, 11.7 vs 7.4; p = 0.047) and the procedure time (247 vs 180 minutes; p = 0.002) were significantly smaller in group B than in group A. The embolized area per internal thoracic artery was significantly larger in group B than in group A (45 vs. 93.5; p < 0.001). All patients underwent Fontan surgery at a mean of 24 days after embolization. Fontan circulation was established in nine of 12 patients. There were no major complications in either group.
In pre-Fontan coil embolization, a combination of longer microcoils (≥30 cm) may help reduce the number of coils used and the procedure time, which may decrease the health care cost and radiation exposure.
我们回顾性分析了弹簧圈类型对Fontan手术前侧支动脉弹簧圈栓塞术所用弹簧圈数量及手术时间的影响。
2010年至2021年间，12例先天性心脏病患者在Fontan手术前行弹簧圈栓塞术。他们被分为两组。A组包括6例在引入更长微弹簧圈（≥30 cm）之前接受弹簧圈栓塞术的患者，B组包括6例在引入微弹簧圈之后接受栓塞术的患者。比较两组的主要终点指标（所用弹簧圈数量、每位患者及胸廓内动脉的栓塞面积、手术时间）。
B组每位患者及胸廓内动脉所用弹簧圈数量（A组 vs. B组：36.5 vs. 18；p = 0.036，11.7 vs 7.4；p = 0.047）及手术时间（247 vs 180分钟；p = 0.002）均显著少于A组。B组每条胸廓内动脉的栓塞面积显著大于A组（45 vs. 93.5；p < 0.001）。所有患者在栓塞术后平均24天接受Fontan手术。12例患者中有9例建立了Fontan循环。两组均未出现重大并发症。
在Fontan手术前弹簧圈栓塞术中，使用更长微弹簧圈（≥30 cm）的联合方式可能有助于减少所用弹簧圈数量及手术时间，这可能降低医疗成本和辐射暴露。
