Microvascular Plug Embolization of Anterior Spinal Artery Bearing Segmental Arteries Prior Aortic Stenting: Technique and Safety.

Purpose: This study aims to present our experience with superselective embolization of the anterior spinal artery-bearing segmental artery (ASAbSA) using a microvascular plug (MVP) during the minimally invasive segmental artery coil embolization (MISACE) procedure prior endovascular repair of the thoracoabdominal aortic aneurysms.

Methods: We retrospectively evaluated all MISACE procedures performed between May 2018 and July 2023, where MVP was deployed into an angiographically confirmed ASAbSA. Data were analyzed regarding interventional details, technical aspects, and safety protocols. The standard procedure for MVP embolization involves detaching the plug after 10 min, provided no neurological symptoms occur.

Results: A total of 22 patients underwent MVP deployment into the proximal segmental artery supplying the ASAbSA. There were no instances of non-target embolization or segmental artery dissection. Furthermore, none of the patients experienced temporary or permanent spinal cord ischemia.

Conclusion: MVP deployment into the ASAbSA is a safe strategy for protecting the spinal cord during preemptive embolization of segmental arteries prior to endovascular aortic repair.