Meta-analysis of Intraprocedural Comparative Effectiveness of Vascular Plugs Vs Coils in Proximal Splenic Artery Embolization and Associated Patient Radiation Exposure |
| |
| Authors: | Paige Johnson Karen Wong Zhengjia Chen Zachary L. Bercu Janice Newsome Derek L. West Sean Dariushnia Laura K. Findeiss Nima Kokabi |
| |
| Affiliation: | 1. University of Arkansas School of Medicine, Little Rock, AR;2. Department of Diagnostic Radiology and Imaging Sciences, Emory School of Medicine, Atlanta, GA;3. Department of Biostatistics and Bioinformatics, Emory University School of Medicine, Atlanta, Georgia, Atlanta, GA;4. Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA;1. Department of Abdominal Imaging, Mallinckrodt Institute of Radiology, Washington University School of Medicine, MO;2. Department of Medicine, University of British Columbia Vancouver General Hospital, Vancouver, British Columbia, Canada;3. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA;4. Department of Emergency & Trauma Radiology, University of British Columbia Vancouver General Hospital, Vancouver, British Columbia, Canada;5. Diagnostic Radiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK;6. Department of Radiology, University of British Columbia Vancouver General Hospital, Vancouver, British Columbia, Canada;7. Department of Accident and Emergency, St Mary''s Hospital – Imperial College Healthcare NHS Trust, London, United Kingdom;8. Department of Emergency & Trauma Radiology, University of British Columbia Vancouver General Hospital, Vancouver, British Columbia, Canada;1. Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL;2. Department of Radiology, Section of Interventional Radiology, The University of Arizona, Tuscon, AZ;3. Department of Endocrinology, Massachusetts General Hospital, Boston, MA;4. Department of Radiology, Section of Vascular and Interventional Radiology, The University of Chicago, Chicago, IL;1. Department of Diagnostic Radiology & Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD.;2. Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.;3. Department of Radiology, RA-3, Brigham & Women''s Hospital, Boston, MA.;4. Spectrum Healthcare Partners, Department of Radiology, Bangor, ME.;1. Department of Radiology, Children''s Healthcare of Atlanta- Egleston Campus, Atlanta, GA;2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA;1. University of Alabama School of Medicine, Birmingham, AL;2. Division of Vascular and Interventional Radiology, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL;3. Division of Vascular and Interventional Radiology, Department of Radiology, University of South Carolina at Greenville, Greenville, SC;4. Division of Vascular and Interventional Radiology, Department of Radiology, Rush University Medical Center, Chicago, IL;1. One Perkins Square, Akron Childrens Hospital, Akron, OH;2. University of Mount Union, Master of Science in Physician Assistant (Stu), Alliance, OH |
| |
| Abstract: | PurposeTo compare vascular plugs to coil embolization of the proximal splenic artery and evaluate differences in radiation exposure to the patients.MethodsAn electronic literature search was performed for relevant studies from January 2000 to July 2018 that compared the efficacy of vascular plugs vs coils in splenic artery embolization. Only studies that investigated coil or vascular plug use, without combination with other embolic agents, were included. Meta-analysis was performed using a fixed effects model approach with the inverse variance-weighted average method to determine pooled differences in time to vessel occlusion, procedure time, fluoroscopy time, total number of devices used, and radiation exposure. Heterogeneity was assessed using the I square statistic. Pooled outcomes were compared, and quality assessments were evaluated using the Newcastle Ottawa Scale.ResultsEight studies met inclusion criteria. 81 patients were embolized with vascular plugs and 52 patients with coils only. The most common indication for splenic artery embolization was trauma. Time to vessel occlusion was shorter in the vascular plug group by 7.11 minutes (P = 0.003). Fluoroscopy time was shorter by 13.82 minutes in the vascular plug cohort, and these patients received less radiation (?439 mGy) compared to the coil group (P = 0.006 and P = 0.02, respectively). The number of devices was significantly fewer in the vascular plug group (?3.54; P < 0.001). Procedure time was not statistically significant.ConclusionOur data supports the vascular plug is superior to coils for embolization of the proximal splenic artery with respect to occlusion time, fluoroscopy time, patient radiation exposure, and number occlusive devices used. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
