Use of a polytetrafluoroethylene-coated vascular plug for focal intracranial parent vessel sacrifice for fusiform aneurysm treatment

Andrew P. Carlson, Mohammad Abbas, Patricia Hall, Christopher Taylor

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)596-602
Number of pages7
JournalOperative Neurosurgery
Volume13
Issue number5
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

Keywords

  • Aneurysm
  • Endovascular embolization
  • Subarachnoid hemorrhage
  • Vertebral dissection

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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