A Single Institution Experience with a Shear-Thinning Conformable Embolic for Endovascular Embolization.

Abstract

Purpose: To assess the safety and efficacy of Obsidio™ conformable embolic (CE) for embolization in the peripheral vasculature.

Materials and methods: A retrospective review of the first 21 patients treated with CE was performed. Eighteen (85.7%) patients were male, and median age was 61.5 years (range, 12-89 years). Technical success was defined as stasis as assessed by a static contrast column for at least 5 heartbeats on post-embolization angiography. For procedures of peripheral vascular hemorrhage, clinical success was defined as hemorrhage resolution without reintervention within 30-day follow-up.

Results: Indications for embolization were peripheral arterial hemorrhage (n = 13), preoperative tumor embolization (n = 4), preoperative embolization of renal cell carcinoma prior to cryoablation (n = 2), redistribution of flow prior to Yttrium-90 radioembolization to prevent nontarget radiation delivery (n = 1), and parastomal variceal embolization (n = 1). Embolization was performed via 2.4 or 2.8 French microcatheters flushed with saline prior to embolization. Most procedures (20/21) utilized < 1 cc of embolic, with the quantity used ranging between 0.1 and 1.4 cc. The amount of embolic injected was determined by the embolization endpoint, i.e., filling of the vessel intended for embolization. CE was used in combination with coils placed prior to CE in 4 procedures. Follow-up was a median of 57 days (range 0-244 days). Complete stasis was achieved in 100% (n = 21/21) of procedures. There were no post-procedure adverse events or rebleeding.

Conclusion: CE resulted in reliable vessel occlusion with no cases of rebleeding or reintervention and with no procedure-related adverse events in this series.

Level of evidence: Level 4, Case Series.