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Initial experiences with the Amplatzer Vascular Plug 4 for permanent occlusion of the internal carotid artery in the skull base in patients with head and neck tumors.
MedLine Citation:
PMID:  21188365     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: As the first report in the literature, we present our initial experiences with the latest generation's Amplatzer Vascular Plug 4 (AVP4) as a device for permanent occlusion of the internal carotid artery in its course in the skull base. METHODS: Permanent occlusion of the internal carotid artery in the skull base was performed in four patients after administration of an intravenous heparin bolus (three patients preoperatively to facilitate radical surgery of head and neck tumors, one patient with a palliative intent to reduce tumor arrosion bleeding risk). RESULTS: In all patients, the deployment of the AVP4 in the artery's course in the skull base was feasible. In two patients, placement was possible in the cavernous segment of the internal carotid artery, and in the other two patients, more proximal in the artery's foramen lacerum and petrous segment, respectively. Occlusion was accomplished in one patient with one AVP4 (occlusion time 25 min), in two patients with two AVP4 (occlusion time 20 min in each case), and in one patient with one AVP4, three additional fibered coils and two Gelfoam pledgets (occlusion time more than 2 h). Complications did not occur in any of the four patients. CONCLUSION: The AVP4 may be a promising device for permanent occlusion of the internal carotid artery, allowing in its latest generation, navigability as distal as the cavernous segment in some, but not in all cases. Difficulties may still occur in very tortuous vessel anatomy.
Authors:
Stephan Macht; Christian Mathys; Jörg Schipper; Bernd Turowski
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-29
Journal Detail:
Title:  Neuroradiology     Volume:  -     ISSN:  1432-1920     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1302751     Medline TA:  Neuroradiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Radiology, Neuroradiology, Medical Faculty, University Düsseldorf, D-40225, Düsseldorf, Germany, stephan.macht@med.uni-duesseldorf.de.
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