Microvascular Plug Embolization of Anterior Spinal Artery Bearing Segmental Arteries Prior Aortic Stenting: Technique and Safety

Sinan Deniz; Osman Öcal; Matthias Fabritius; Daniel Puhr-Westerheide; Gizem Abaci; Moritz Wildgruber; Muzaffer Reha Ümütlü; Mustafa Gök; Jan Stana; Barbara Rantner; Nikolaos Tsilimparis; Jens Ricke; Max Seidensticker

doi:10.1007/s00270-024-03909-4

Microvascular Plug Embolization of Anterior Spinal Artery Bearing Segmental Arteries Prior Aortic Stenting: Technique and Safety

Cardiovasc Intervent Radiol. 2024 Nov 27. doi: 10.1007/s00270-024-03909-4. Online ahead of print.

Authors

Affiliations

¹ Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany. sinan.deniz@med.uni-muenchen.de.
² Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
³ Department of Diagnostic and Interventional Radiology, Heidelberg University, Heidelberg, Germany.
⁴ Department of Radiology, Adnan Menderes University, Aydin, Türkiye.
⁵ Sydney Medical School and School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁶ Department of Vascular Surgery, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.
⁷ Department of Radiology, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany. max.seidensticker@med.uni-muenchen.de.

PMID: 39604696
DOI: 10.1007/s00270-024-03909-4

Abstract

Purpose: This study aims to present our experience with superselective embolization of the anterior spinal artery-bearing segmental artery (ASAbSA) using a microvascular plug (MVP) during the minimally invasive segmental artery coil embolization (MISACE) procedure prior endovascular repair of the thoracoabdominal aortic aneurysms.

Methods: We retrospectively evaluated all MISACE procedures performed between May 2018 and July 2023, where MVP was deployed into an angiographically confirmed ASAbSA. Data were analyzed regarding interventional details, technical aspects, and safety protocols. The standard procedure for MVP embolization involves detaching the plug after 10 min, provided no neurological symptoms occur.

Results: A total of 22 patients underwent MVP deployment into the proximal segmental artery supplying the ASAbSA. There were no instances of non-target embolization or segmental artery dissection. Furthermore, none of the patients experienced temporary or permanent spinal cord ischemia.

Conclusion: MVP deployment into the ASAbSA is a safe strategy for protecting the spinal cord during preemptive embolization of segmental arteries prior to endovascular aortic repair.

Keywords: Angiography; Anterior spinal artery; Coils; Embolization; Microvascular plug; Segmental artery; Spinal cord ischemia.