Objective: To evaluate our initial experience with hypogastric artery occlusion using a nitinol vascular plug during endovascular aortic aneurysm repair (EVAR).
Methods: We reviewed the records and images of 23 consecutive patients who underwent transluminal vessel occlusion of the hypogastric artery with a nitinol plug, as well as a cohort of 19 patients who underwent hypogastric artery embolization with coils in conjunction with EVAR.
Results: There were no demographic differences between the two groups of patients. Hypogastric artery occlusion was successful in all cases when a nitinol vascular plug was used. When coils were used, there was one unsuccessful embolization which required a second procedure. The number of embolic devices used in the coil group was 7.53 (range, three to 13) compared with 1.35 (range, one to six) in the plug group (P < .05). Only one plug was used in 19 of 23 cases. The average cost to embolize per hypogastric artery was $1,496 compared with $470 when a nitinol plug was used. There were two instances of coil migration. No other intraoperative complications occurred. At one month follow up, seven patients (35%) in the coil group complained of buttock claudication compared with two patients (9%) in the nitinol plug group (P = .027).
Conclusion: Our experience demonstrates the safety and effectiveness of the nitinol vascular plug for hypogastric artery occlusion during EVAR. When compared with coils for hypogastric embolization during EVAR, nitinol vascular plugs are less expensive, produce less technical complications, and are associated with a significantly lower incidence of gluteal claudication.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jvs.2008.06.002 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Novel pain management strategy for uterine fibroid embolization.
CVIR Endovasc
January 2025
Department of Medical Imaging, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
Background: Uterine fibroid embolization can be associated with significant pain due to fibroid ischemia and interventions of the procedure itself. Fentanyl and midazolam are commonly provided for sedation and pain relief, but are not tolerated by all patients. This report outlines a novel pain management strategy for uterine fibroid embolization in a patient who could not receive either opioids or benzodiazepines.
View Article and Find Full Text PDFPerioperative and mid-term results of trans-graft embolization of the hypogastric artery for treatment of type II endoleaks after endovascular aortic repair with off-label use of re-entry catheters.
J Vasc Surg Cases Innov Tech
February 2025
Division of Vascular and Endovascular Surgery, Cardio-Thoracic-Vascular Department, Integrated University Healthcare Giuliano-Isontina, University Hospital of Cattinara, Trieste, Italy.
Type II endoleaks after endovascular aortic repair are a common scenario that, although infrequently, may sometimes require secondary interventions when leading to significant enlargement of the aneurysm sac. Herein, we present the perioperative and mid-term results of one of our endovascular aortic repair cases with type II endoleak from the hypogastric artery, whose ostium was covered by the prior stent graft limbs and that were successfully treated with a novel technique employing re-entry catheters in an off-label fashion. This technique may represent a valid alternative solution when conventional access between artery and prosthesis is laborious or impossible to achieve.
View Article and Find Full Text PDFIliac branch endoprosthesis for endovascular treatment of complex aorto-iliac aneurysms - from device design to practical experience: how to translate physiology considerations into clinical applications.
Exp Physiol
November 2024
Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
Article Synopsis
- - This article reviews current literature and expert opinions on using iliac branch endoprosthesis (IBE) for treating complex abdominal aortic aneurysms (AAA) that also involve the iliac arteries.
- - Around 25% of AAA patients have aneurysms that extend into ilac vessels, complicating standard endovascular aortic repair (EVAR) procedures and requiring careful assessment to ensure proper treatment.
- - The IBE is shown to be an effective and durable treatment option for complex aorto-iliac aneurysms, offering results comparable to open surgery but with lower risks, while also preserving pelvic circulation to avoid potential complications.
Physician-Modified Fenestrated Endovascular Aortic Repair for the Preservation of Hypogastric Artery Perfusion and Efficacy of Hydrogel Coil Fenestration Reinforcement.
Ann Vasc Surg
November 2024
Department of Radiology, Nara Medical University, Kashihara, Japan.
Background: Extending the distal sealing zone into the external iliac artery is sometimes necessary during endovascular abdominal aortic repair. As the use of an iliac branch device is contingent upon certain anatomical requirements, the application of this device is not universal. Herein, we present an alternative method to preserve hypogastric artery perfusion using a physician-modified fenestrated (PMF) AFX limb (Endologix, Inc.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!