Coil Embolization with Side-Holed Catheter to Preserve Peripheral Flow for Visceral Artery Pseudoaneurysm: An Experimental Study in Swine |
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| Affiliation: | 1. Division of Radiology, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, 36-1 Nishicho, Yonago, Tottori 683-8504 Japan;2. Department of Radiology, Sanin Rosai Hospital, Yonago;3. Department of Radiology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan;1. Department of Radiology, University of Chicago Medicine, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60636;2. Wright State University Boonshoft School of Medicine, Dayton, Ohio;1. Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei;2. Department of Medical Imaging, National Taiwan University Hospital and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan;3. Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan;4. Department of Medical Imaging, National Taiwan University Hospital Yun Lin Branch, Yun-Lin, Taiwan.;1. Laboratory for Minimally Invasive Tumor Therapies, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, WCC 308-B, Boston, MA 02215;2. Division of Image-guided Therapy and Interventional Oncology, Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel;3. Department of Pharmaceutical Sciences and Center for Pharmaceutical Biotechnology and Nanomedicine, Northeastern University, Boston, Massachusetts;1. Department of Radiology, University of Wisconsin, 1111 Highland Avenue, WIMR 1310-O, Madison, WI 53705;2. Department of Biomedical Engineering, University of Wisconsin, 1111 Highland Avenue, WIMR 1310-O, Madison, WI 53705;1. Department of Radiology, Wakayama Medical University, 811-1, Kimiidera Wakayama 641-8510, Japan;2. Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, 811-1, Kimiidera Wakayama 641-8510, Japan |
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| Abstract: | PurposeTo evaluate the safety and efficacy of coil embolization with an indwelling catheter with side holes to control visceral artery bleeding while simultaneously preserving peripheral artery flow.Materials and MethodsA 6-F anticoagulant-coated catheter with two symmetrically arranged side holes was used with coil embolization to induce hemostasis in the superior mesenteric artery (SMA) of 13 pigs. The SMA was punctured with a metal needle to induce bleeding. The catheter was advanced into the SMA immediately after the puncture, and the midpoint between its tip and side holes was adjusted to conform to the puncture site. The SMA was embolized by using microcoils placed around the catheter to achieve hemostasis. Hemostasis and gross ischemic changes of the intestine were visually observed during the abdominal surgery. Peripheral blood flow was assessed by using abdominal aortography for as long as 2 hours in 13 pigs and was assessed again at 7 days in three pigs.ResultsAntegrade peripheral artery flow through the indwelling catheter was preserved without stagnation for as long as 2 hours in all 13 pigs and at 7 days in two of three pigs. One catheter occlusion was seen at the 7-day time point. There were no observable instances of recurrent bleeding, ischemic changes in the intestine, or vascular adverse events during or after the procedure.ConclusionsThe hemostatic method described here is a technically feasible method of controlling acute visceral artery bleeding while preserving peripheral artery flow and may be particularly useful in cases of absence of collateral circulation. Further experiments are warranted for clinical application. |
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| Keywords: | SMA" },{" #name" :" keyword" ," $" :{" id" :" key0010" }," $$" :[{" #name" :" text" ," _" :" superior mesenteric artery |
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