TY - JOUR
T1 - Use of a polytetrafluoroethylene-coated vascular plug for focal intracranial parent vessel sacrifice for fusiform aneurysm treatment
AU - Carlson, Andrew P.
AU - Abbas, Mohammad
AU - Hall, Patricia
AU - Taylor, Christopher
PY - 2017/10/1
Y1 - 2017/10/1
N2 - BACKGROUND: Fusiform intracranial aneurysms are challenging due to the circumferential nature of the disease. Endovascular parent vessel sacrifice with coils may be a treatment option, but typically requires a long vessel segment to induce complete cessation of flow.OBJECTIVE: We evaluate early clinical experience with the intracranial use of the microvascular plug (MVP; Medtronic, Dublin, Ireland) device and to compare to previous coil-only techniques for vertebral artery sacrifice for fusiform vertebral aneurysm.METHODS: We reviewed patients treated with the MVP for intracranial aneurysms at our institution. As a case-control study, we located 6 control patients who underwent coiling alone for vertebral artery sacrifice. The number of implants, fluoroscopy time, and procedural charges were compared using unpaired t-tests.RESULTS: Twelve patients underwent vessel sacrifices with MVP. Eight were for vertebral artery dissecting aneurysms. Comparing only vertebral aneurysms, the mean implants was 7 in the MVP group (n = 8) and 19.5 in the coiling group (n = 6; P = .0015). Mean fluoroscopy time was 17.62 min in the MVP group compared to 24.2 min in the coiling group (P = .07). Procedural costs were less in the MVP group ($19 667.38) compared to coiling ($44 909.50, P = .05). There were no technical failures and no cases with persistent flow in the parent vessel at the end of the procedure.CONCLUSION: The MVP is a cost-effective device for focal intracranial vessel occlusion in select patients. This is an important tool for cerebrovascular surgeons, particularly in cases of ruptured dissecting vertebral aneurysms.
AB - BACKGROUND: Fusiform intracranial aneurysms are challenging due to the circumferential nature of the disease. Endovascular parent vessel sacrifice with coils may be a treatment option, but typically requires a long vessel segment to induce complete cessation of flow.OBJECTIVE: We evaluate early clinical experience with the intracranial use of the microvascular plug (MVP; Medtronic, Dublin, Ireland) device and to compare to previous coil-only techniques for vertebral artery sacrifice for fusiform vertebral aneurysm.METHODS: We reviewed patients treated with the MVP for intracranial aneurysms at our institution. As a case-control study, we located 6 control patients who underwent coiling alone for vertebral artery sacrifice. The number of implants, fluoroscopy time, and procedural charges were compared using unpaired t-tests.RESULTS: Twelve patients underwent vessel sacrifices with MVP. Eight were for vertebral artery dissecting aneurysms. Comparing only vertebral aneurysms, the mean implants was 7 in the MVP group (n = 8) and 19.5 in the coiling group (n = 6; P = .0015). Mean fluoroscopy time was 17.62 min in the MVP group compared to 24.2 min in the coiling group (P = .07). Procedural costs were less in the MVP group ($19 667.38) compared to coiling ($44 909.50, P = .05). There were no technical failures and no cases with persistent flow in the parent vessel at the end of the procedure.CONCLUSION: The MVP is a cost-effective device for focal intracranial vessel occlusion in select patients. This is an important tool for cerebrovascular surgeons, particularly in cases of ruptured dissecting vertebral aneurysms.
KW - Aneurysm
KW - Endovascular embolization
KW - Subarachnoid hemorrhage
KW - Vertebral dissection
UR - http://www.scopus.com/inward/record.url?scp=85030675198&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030675198&partnerID=8YFLogxK
U2 - 10.1093/ons/opx006
DO - 10.1093/ons/opx006
M3 - Article
C2 - 28922877
AN - SCOPUS:85030675198
VL - 13
SP - 596
EP - 602
JO - Operative Neurosurgery
JF - Operative Neurosurgery
SN - 2332-4252
IS - 5
ER -