Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy

• Published in: Cardiovascular and interventional radiology 2017-02, Vol.40 (2), p.210-215
• Main Authors: Jambon, E., Petitpierre, F., Brizzi, V., Dubuisson, V., Le Bras, Y., Grenier, N., Cornelis, F.
• Format: Article
• Language: English
• Subjects: ABSCESSES; Adolescent; Adult; Aged; Aged, 80 and over; Angiography - methods; ARTERIES; BIOMEDICAL RADIOGRAPHY; Cardiology; Child; Clinical Investigation; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Female; FISTULAE; Follow-Up Studies; FRANCE; Humans; Imaging; KIDNEYS; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; PATIENTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Retrospective Studies; SAFETY; Treatment Outcome; Ultrasound; VASCULAR DISEASES; Vascular Diseases - diagnostic imaging; Vascular Diseases - therapy; VEINS; Young Adult
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-016-1480-5

Purpose To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD). Materials and Methods From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10–86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up. Results To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess. Conclusion The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.