Abstract
The purpose of this study was compare embolization of the gastroduodenal artery (GDA) using standard pushable coils with the Interlock detachable coil (IDC), a novel fibered mechanically detachable long microcoil, in patients scheduled for selective internal radiotherapy (SIRT). Fifty patients (31 male and 19 female; median age 66.6 ± 8.1 years) were prospectively randomized for embolization using either standard coils or IDCs. Procedure time, radiation dose, number of embolization devices, complications, and durability of vessel occlusion at follow-up angiography were recorded. The procedures differed significantly in time (14:32 ± 5:56 min for standard coils vs. 2:13 ± 1:04 min for IDCs; p < 0.001); radiation dose for coil deployment (2479 ± 1237 cGycm² for standard coils vs. 275 ± 268 cGycm² for IDCs; p < 0.001); and vessel occlusion (17:18 ± 6:39 min for standard coils vs. 11:19 ± 7:54 min for IDCs; p = 0.002). A mean of 6.2 ± 1.8 coils (n = 27) were used in the standard coil group, and 1.3 ± 0.9 coils (p < 0.0001) were used in the IDC group (n = 23) because additional pushable coils were required to achieve GDA occlusion in 4 patients. In 2 patients, the IDC could not be deployed through a Soft-VU catheter. One standard coil dislodged in the hepatic artery and was retrieved. Vessel reperfusion was noted in only 1 patient in the standard coil group. Controlled embolization of the GDA with fibered IDCs was achieved more rapidly than with pushable coils. However, vessel occlusion may not be obtained using a single device only, and the use of sharply angled guiding catheters hampered coil pushability.
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References
Quick AM, Lo SS, Mayr NA et al (2009) Radiation therapy for intrahepatic malignancies. Expert Rev Anticancer Ther 9:1511–1521
Dubel GJ, Soares GM (2008) Regional infusion-radioembolization. Surg Oncol Clin North Am 17:957–985 xii
Ibrahim SM, Lewandowski RJ, Sato KT et al (2008) Radioembolization for the treatment of unresectable hepatocellular carcinoma: a clinical review. World J Gastroenterol 14:1664–1669
Riaz A, Lewandowski RJ, Kulik L et al (2009) Yttrium-90 radioembolization using TheraSphere in the management of primary and secondary liver tumors. Q J Nucl Med Mol Imaging 53:311–316
Welsh JS, Kennedy AS, Thomadsen B (2006) Selective internal radiation therapy (SIRT) for liver metastases secondary to colorectal adenocarcinoma. Int J Radiat Oncol Biol Phys 66(Suppl 2):S62–S73
Konda A, Savin M, Cappell M, Duffy M (2009) Radiation microsphere-induced GI ulcers after selective internal radiation therapy for hepatic tumors: an underrecognized clinical entity. Gastrointest Endosc 70:561–567
Thamboo TP, Wai CT, Lim LG et al (2008) Late gastric ulceration and cytomegalovirus infection following selective internal radiation therapy (SIRT) of the liver. Pathology 40:303–305
Pech M, Kraetsch A, Wieners G et al (2009) Embolization of the gastroduodenal artery before selective internal radiotherapy: a prospectively randomized trial comparing platinum-fibered microcoils with the Amplatzer Vascular Plug II. Cardiovasc Intervent Radiol 32:455–461
Liu DM, Salem R, Bui JT et al (2005) Angiographic considerations in patients undergoing liver-directed therapy. J Vasc Interv Radiol 16:911–935
Yang FS, Ohta I, Chiang HJ et al (1994) Non-surgical retrieval of intravascular foreign body: experience of 12 cases. Eur J Radiol 18:1–5
Gabelmann A, Kramer S, Gorich J (2001) Percutaneous retrieval of lost or misplaced intravascular objects. AJR Am J Roentgenol 176:1509–1513
Sheth R, Someshwar V, Warawdekar G (2007) Percutaneous retrieval of misplaced intravascular foreign objects with the Dormia basket: an effective solution. Cardiovasc Intervent Radiol 30:48–53
Chuang VP, Wallace S, Gianturco C et al (1981) Complications of coil embolization: prevention and management. AJR Am J Roentgenol 137:809–813
Cekirge HS, Saatci I, Firat MM et al (1996) Interlocking detachable coil occlusion in the endovascular treatment of intracranial aneurysms: preliminary results. AJNR Am J Neuroradiol 17:1651–1657
Irie K, Taki W, Nakahara I et al (1997) Endovascular treatment of a partially thrombosed giant basilar tip aneurysm using interlocking detachable coils―case report. Neurol Med Chir (Tokyo) 37:681–684
Kinoshita A, Ito M, Skakaguchi T et al (1994) Mechanical detachable coil as a therapeutic alternative for cerebral aneurysm. Neurol Res 16:475–476
Mori T, Sugimoto K, Taniguchi T et al (2004) Renal arteriovenous fistula with rapid blood flow successfully treated by transcatheter arterial embolization: application of interlocking detachable coil as coil anchor. Cardiovasc Intervent Radiol 27:374–376
Reidy JF, Qureshi SA (1996) Interlocking detachable platinum coils, a controlled embolization device: early clinical experience. Cardiovasc Intervent Radiol 19:85–90
Takahashi K, Tanimura K, Honda M et al (1999) Venous sac embolization of pulmonary arteriovenous malformation: preliminary experience using interlocking detachable coils. Cardiovasc Intervent Radiol 22:210–213
Seltzer S, Aboulhosn J, Levi DS (2009) Use of interlock fibered detachable coils for occlusion of collaterals, coronary artery fistulae, and patent ductus arteriosus. Catheter Cardiovasc Interv 74:770–776
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Dudeck, O., Bulla, K., Wieners, G. et al. Embolization of the Gastroduodenal Artery Before Selective Internal Radiotherapy: A Prospectively Randomized Trial Comparing Standard Pushable Coils with Fibered Interlock Detachable Coils. Cardiovasc Intervent Radiol 34, 74–80 (2011). https://doi.org/10.1007/s00270-010-9845-7
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DOI: https://doi.org/10.1007/s00270-010-9845-7