Superiority of Proximal Embolization of the Gastroduodenal Artery with the Amplatzer Vascular Plug 4 Before Yttrium-90 Radioembolization: A Retrospective Comparison with Coils in 134 Patients

• Published in: Cardiovascular and interventional radiology 2014-04, Vol.37 (2), p.396-404
• Main Authors: Bulla, Karsten, Hubich, Sebastian, Pech, Maciej, Löwenthal, David, Ricke, Jens, Dudeck, Oliver
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arteries; Cardiology; Clinical Investigation; Cohort Studies; Duodenum - blood supply; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Equipment Design; Female; Follow-Up Studies; Humans; Imaging; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Radiology; Retrospective Studies; Risk Assessment; Septal Occluder Device; Stomach - blood supply; Treatment Outcome; Ultrasound; Yttrium Radioisotopes - therapeutic use
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-013-0684-1

Purpose To evaluate the effectiveness of proximal embolization of the gastroduodenal artery (GDA) using the Amplatzer Vascular Plug 4 (AVP 4) compared with pushable coils to avoid hepaticoenteric collaterals of the GDA stump, which may serve as pathways for nontarget embolization. Materials and Methods One hundred thirty-four patients scheduled for 90-yttrium radioembolization (Y-90 RE) using either plugs ( n  = 67) or standard coils ( n  = 67) for GDA occlusion were retrospectively analyzed. Parameters recorded were length of the perfused GDA stump, distance device to the GDA origin, perfused proximal side branches after embolization, and durability of vessel occlusion at Y-90 RE. Results Length of the residually perfused GDA stump was 3.89 ± 2.86 mm for the AVP 4, which was significantly shorter compared with 5.78 ± 3.85 mm for coils ( p  = 0.005). Distance of the plug to the GDA origin was 1.41 ± 2.60 mm, which was also significantly shorter than 4.73 ± 3.44 mm for coils ( p