Splenic Artery Embolization and Endovascular Stapler Integrity in a Porcine Model

Splenic artery embolization is often used before laparoscopic splenectomy in cases of splenomegaly to reduce blood loss and facilitate the procedure. The aim of this study was to examine the general reliability of endovascular staplers when fired at the site of embolization coil deployment using a p...

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Bibliographic Details
Published in:The American surgeon 2008-04, Vol.74 (4), p.322-326
Main Authors: BELLOWS, Charles F, CHOI, Yong U, SWEENEY, John F, JAFFE, Bernard M, DOMINGUEZ, Edward P
Format: Article
Language:English
Subjects:
Angioplasty - instrumentation
Animals
Aorta, Abdominal - surgery
Biological and medical sciences
Blood transfusions
Embolization, Therapeutic - instrumentation
Failure
Female
General aspects
Hemostasis, Surgical - instrumentation
Laparoscopy
Male
Materials Testing
Medical sciences
Reproducibility of Results
Splenectomy
Splenic Artery - surgery
Studies
Surgical Staplers
Swine
Veins & arteries
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Summary:Splenic artery embolization is often used before laparoscopic splenectomy in cases of splenomegaly to reduce blood loss and facilitate the procedure. The aim of this study was to examine the general reliability of endovascular staplers when fired at the site of embolization coil deployment using a porcine model. Ex vivo and in vivo experiments were conducted on porcine abdominal aortas, which are similar in diameter to those of the splenic artery in the human. When the endovascular staplers were fired across the porcine vessels at the area of embolization coil deployment ex vivo, the staple lines all failed. In contrast, in vivo, the staple lines remained intact with no bleeding despite resistance imposed by the intravascular coils. Despite consistent failure in the ex vivo studies, in vivo all staple lines held and permitted safe transection of the vessel. We presume that the hemostatic properties of the coils caused sufficient thrombosis in this model, which mimics the clinical situation, to permit division of the previously embolized splenic vessel.
ISSN:0003-1348
1555-9823
DOI:10.1177/000313480807400409