CVIR EndovascularPub Date : 2025-03-20DOI: 10.1186/s42155-025-00535-0
Hamza Sawalha, Olivier Chevallier, Mohamed Fouad, Taninokuchi Tomassini Makoto, Comby Pierre-Olivier, Ludwig Serge Aho-Glele, Romaric Loffroy
{"title":"Transcatheter arterial and venous embolisation with α-hexyl cyanoacrylate MagicGlue®: short-term safety and efficacy outcomes.","authors":"Hamza Sawalha, Olivier Chevallier, Mohamed Fouad, Taninokuchi Tomassini Makoto, Comby Pierre-Olivier, Ludwig Serge Aho-Glele, Romaric Loffroy","doi":"10.1186/s42155-025-00535-0","DOIUrl":"10.1186/s42155-025-00535-0","url":null,"abstract":"<p><strong>Purpose: </strong>Our purpose was to assess the feasibility and the short-term safety and efficacy outcomes of a wide range of transcatheter arterial and venous embolisation procedures done using α-hexyl-cyanoacrylate (AHCA)-MagicGlue® in patients with bleeding and non-bleeding disorders.</p><p><strong>Methods: </strong>This single-centre retrospective study included consecutive patients who underwent emergent or planned AHCA-MagicGlue® transcatheter embolisation between February 2019 and September 2023. Technical success, clinical success, 30-day mortality, and complication rates were evaluated.</p><p><strong>Results: </strong>We included 101 patients with a mean age of 49.9 ± 20.5 years who underwent arterial (n = 43, 42.6%) or venous (n = 58, 57.4%) embolisation for bleeding (n = 16, 15.8%) or other reasons (n = 85, 84.2%). The technical success rate was 100%. After a mean follow-up of 2.2 months, the clinical success rate was 94% in patients with bleeding and 95% in other patients; 1 patient died of multi-organ failure unrelated to the procedure. In the 22 patients with prostatic artery embolisation, statistically significant improvements were recorded at 3 months versus baseline for the International Prostate Symptoms Score (IPSS) (10.0 ± 5.8 vs. 20.8 ± 7.3, p = 0.001), IPSS quality-of-life score (2.0 ± 1.4 vs. 5.0 ± 1.0; p = 0.001), and prostate volume (67.8 ± 38.0 mL vs. 96.7 ± 47.4 mL, p = 0.001). Adverse events occurred in 11 (10.9%) patients and were major in 4 and minor in 7 patients.</p><p><strong>Conclusions: </strong>MagicGlue® transcatheter arterial and venous embolisation is feasible, effective, and safe for bleeding and non-bleeding conditions across a broad range of anatomic sites.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"25"},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-19DOI: 10.1186/s42155-025-00525-2
Tony Rizk, Derek Groskreutz, Carl Forsberg, Stephen Stringfellow, Ricardo Yamada, Marcelo Guimaraes, Yara Younan, Antony Gayed
{"title":"Portal vein reconstruction in iatrogenic portal vein ligation.","authors":"Tony Rizk, Derek Groskreutz, Carl Forsberg, Stephen Stringfellow, Ricardo Yamada, Marcelo Guimaraes, Yara Younan, Antony Gayed","doi":"10.1186/s42155-025-00525-2","DOIUrl":"10.1186/s42155-025-00525-2","url":null,"abstract":"<p><p>Laparoscopic cholecystectomy for acute cholecystitis is one of the most performed surgeries and is generally regarded as a safe procedure with a low risk of complications. Vascular and biliary injuries are rare but have severe consequences. No systematic studies have been performed to delineate optimal treatment strategies in these scenarios, which are typically managed on a case-by-case basis. The present report describes a patient who underwent a laparoscopic cholecystectomy, complicated by common bile duct and main portal vein ligation, resulting in hepatic infarcts, perihepatic abscess, and portal hypertension with ascites and portomesenteric congestive enteropathy. This case focuses on management of this patient's vascular injury, which was successfully treated by endovascular portal venous reconstruction using trans-splenic and right internal jugular vein access.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"24"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-19DOI: 10.1186/s42155-025-00533-2
Marilia B Voigt, Patrick A Kupczyk, Alexander Kania, Carsten Meyer, Julia Wagenpfeil, Tatjana Dell, Claus-Christian Pieper, Julian A Luetkens, Daniel Kuetting
{"title":"Interventional treatment of peripancreatic aneurysms: can one strategy fit all?","authors":"Marilia B Voigt, Patrick A Kupczyk, Alexander Kania, Carsten Meyer, Julia Wagenpfeil, Tatjana Dell, Claus-Christian Pieper, Julian A Luetkens, Daniel Kuetting","doi":"10.1186/s42155-025-00533-2","DOIUrl":"10.1186/s42155-025-00533-2","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the frequency and association of visceral arterial (VA) stenosis in peripancreatic aneurysms (PPAs) and to develop a uniform, more detailed treatment strategy for PPAs in case of accompanying VA stenosis, as current guidelines do not adequately address this constellation.</p><p><strong>Materials and methods: </strong>Patients with PPAs diagnosed at a tertiary care hospital were retrospectively analyzed. In case of multiple PPAs, the aneurysm with the highest aneurysm-to-vessel ratio (AVR) within the celiac-mesenteric collateral circulation was classified as the primary aneurysm and categorized as \"critical\" or \"non-critical\" based on the risk of organ ischemia. Celiac artery and superior mesenteric artery stenoses were graded as low (< 50%), high (> 50%), or total occlusion. Treatment strategies were based on VA stenosis severity, aneurysm classification, and morphology. Treatment strategies included endovascular, surgical and watch-and-wait management.</p><p><strong>Results: </strong>Thirty-one patients with PPAs were included with a total of 53 aneurysms; mean aneurysm size: 12.5 ± 7.9 mm (range 5-38 mm), AVR: 3.5 ± 2.1 (range 1-11.3). The superior and inferior pancreaticoduodenal arteries as well as the pancreaticoduodenal arcade were affected in most cases (67.9%). AVR was significantly higher in cases of aneurysm rupture (6.2 ± 2.8; p = 0.031). Celiac artery stenosis was present in 87.1%. Aneurysm size and occurrence of active bleeding did not correlate (p = 0.925). 11 patients presented with critical aneurysms, with 10 patients requiring individually tailored treatment. Non-critical aneurysms were treated with coil embolization in most cases.</p><p><strong>Conclusion: </strong>CA stenosis, aneurysm position, and AVR significantly influence treatment decisions. Individualized approaches based on anatomical and hemodynamic factors are needed in PPA treatment.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"23"},"PeriodicalIF":1.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"PseuSeal technique: endovascular repair of Iatrogenic pseudoaneurysm using ExoSeal.","authors":"Takuya Haraguchi, Yuhei Kasai, Masanaga Tsujimoto, Yoshifumi Kashima, Katsuhiko Sato, Tsutomu Fujita","doi":"10.1186/s42155-025-00536-z","DOIUrl":"10.1186/s42155-025-00536-z","url":null,"abstract":"<p><strong>Introduction: </strong>The ExoSeal<sup>®</sup> (Cordis, Florida, USA) is a bioabsorbable vascular closure device that facilitates hemostasis by deploying a polyglycolic acid (PGA) plug. This report presents the \"PseuSeal technique,\" a novel approach to seal pseudoaneurysm using ExoSeal in an off-label manner.</p><p><strong>Methods: </strong>The PseuSeal technique includes the PseuSeal Snare and PseuSeal Rendezvous, both performed via a contralateral crossover approach. The choice of approach depends on whether a 4-Fr catheter can be advanced into the pseudoaneurysm cavity. If feasible, the PseuSeal Snare is selected; otherwise, the PseuSeal Rendezvous is employed. In the PseuSeal Snare, a snare is deployed from a 4-Fr catheter within the pseudoaneurysm cavity. An 18-gauge needle is then used to retrogradely puncture the snare loop. A 0.035-inch guidewire is passed through the needle lumen, captured by the snare, and externalized. In the PseuSeal Rendezvous, an 18-gauge needle retrogradely punctures the guidewire within the cavity, and the guidewire is advanced into the needle lumen for externalization. After externalizing the guidewire in both approaches, an ExoSeal-specific sheath is inserted over the guidewire through the pseudoaneurysm neck into the main vessel. A balloon is advanced from the crossover sheath into the main trunk to cover the pseudoaneurysm ostium. The ExoSeal system is then inserted through the second sheath. As the ExoSeal's indicator wire is withdrawn, the balloon is inflated to stabilize the indicator wire, ensuring precise deployment of the PGA plug at the pseudoaneurysm neck. Balloon inflation is maintained for 5 minutes, with an additional 5 minutes if necessary. Hemostasis is confirmed by angiography.</p><p><strong>Results: </strong>The PseuSeal technique was successfully applied in five common femoral artery pseudoaneurysms, all of which had failed ultrasound-guided compression. Each case was treated using a 6-Fr ExoSeal device, with no complications or recurrences observed during follow-up. Case 1 involved an 87-year-old female who developed a pseudoaneurysm following a peripheral intervention. The PseuSeal Snare achieved hemostasis in 32 minutes. Case 2 involved a 60-year-old male presenting with a pseudoaneurysm after a coronary intervention. The PseuSeal Rendezvous achieved hemostasis in 50 minutes.</p><p><strong>Conclusion: </strong>The PseuSeal technique provides an effective alternative for pseudoaneurysm closure.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"21"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-17DOI: 10.1186/s42155-024-00508-9
Ajay Alex, Praveen A, Niwin George, Vinu C V, Radhika Devi B, Neetha Jose
{"title":"Percutaneous vascular plug in management of an acquired broncho pleural cutaneous fistula.","authors":"Ajay Alex, Praveen A, Niwin George, Vinu C V, Radhika Devi B, Neetha Jose","doi":"10.1186/s42155-024-00508-9","DOIUrl":"10.1186/s42155-024-00508-9","url":null,"abstract":"<p><strong>Background: </strong>Bronchopleural fistula (BPF) / broncho pleural cutaneous fistula is an abnormal communication between the peripheral bronchial tree and pleural space which can further also open to the skin surface. It is associated with significant morbidity and mortality in addition to poor quality of life. Management requires a multidisciplinary approach with careful evaluation to choose the best approach to treatment.</p><p><strong>Case presentation: </strong>A 36-year-old male presented with a left chest wall tumor with multiple surgeries and CT revealing a left apico-posterior segment broncho pleural cutaneous fistula. Various options for the management of the BPCF including surgery and bronchoscopic occlusion were considered however an IR approach was planned. Plan was for vascular plug occlusion with/without glue embolization of the apico-posterior segmental bronchus. A 6F sheath was placed under direct vision and a 12 mm CERA plug was deployed. After plain plug occlusion, there were no signs of air leak. Various options for management including surgery and bronchoscopy procedures are limited in patients with poor pulmonary reserve. The IR approach offers the advantage of doing the procedure under real-time fluoroscopy, and no airway compromise. However, literature describes the use of glue to seal the interstices of the device which if not sealed was a cause of recurrence later. In our case, we report the percutaneous use of a CERA vascular plug as the sole device, especially since it has a polytetrafluoroethylene (PTFE) membrane which ensures occlusion, in addition to its titanium nitride coating which improves epithelialization. This ensures sustained occlusion as the sole agent, unlike other devices including the Amplatzer vascular plug.</p><p><strong>Conclusions: </strong>This highlights the relatively easy percutaneous route and the first report of CERA vascular plug usage for managing a case of broncho pleural cutaneous fistula.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"22"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-17DOI: 10.1186/s42155-025-00534-1
Rémi Grange, Nicolas Magand, Noémie Lutz, Bertrand Le Roy, Claire Boutet, Sylvain Grange
{"title":"Embolization of ruptured pancreaticoduodenal arcade aneurysms due to median arcuate ligament without celiac artery revascularization: a single-center experience and literature review.","authors":"Rémi Grange, Nicolas Magand, Noémie Lutz, Bertrand Le Roy, Claire Boutet, Sylvain Grange","doi":"10.1186/s42155-025-00534-1","DOIUrl":"10.1186/s42155-025-00534-1","url":null,"abstract":"<p><strong>Background: </strong>The aim of this single-center retrospective study is to evaluate the feasibility, complications, and outcomes of transarterial embolization (TAE) for ruptured pancreaticoduodenal arcades aneurysms (PDAAs) due to median arcuate ligament (MAL), without subsequent revascularization of celiac artery (CA) occlusion/stenosis.</p><p><strong>Methods: </strong>Between January 1<sup>st</sup> 2012 and June 1<sup>st</sup> 2024, all records from adult patients (≥ 18 years old) referred to our hospital for TAE due to ruptured PDAAs were retrospectively reviewed. All referrals were based on emergency clinical decisions and computed tomography. Procedure data included procedure, type of embolic agent and per-procedural complication. TAE technical success was defined as the cessation of aneurysm opacification immediately after the TAE, based on angiographic findings. Overall technical success was defined as the cessation of aneurysm opacification after TAE or percutaneous salvage approach during the same session. Then, we analyzed all published original articles published between January 2007 and December 2024 on emergency TAE of ruptured PDAAs due to MAL, without subsequent treatment of CA stenosis/occlusion.</p><p><strong>Results: </strong>Nine patients (4 males) were referred for TAE for ruptured PDAAs due to MAL in our center. TAE technical success was achieved in 7/9 patients, and overall technical success was achieved in all patients. There were no major complications. No patients had rebleeding during follow-up. We reviewed four retrospective studies including 29 patients treated for ruptured PDAAs due to MAL without subsequent treatment of CA stenosis/occlusion. No patient received additional treatment for CA stenosis/occlusion. No aneurysm recurrence was diagnosed during the reported follow-up periods ranging from 1 to 65 months.</p><p><strong>Conclusion: </strong>TAE for ruptured PDAAs without CA revascularization is safe and should be considered, although further studies are required to validate its validity and long-term outcomes.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"20"},"PeriodicalIF":1.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-11DOI: 10.1186/s42155-024-00512-z
Ahmad Arar, Samuel L Rice, Mhd Wisam Alnablsi, Akhilesh Pillai, Jamaal Benjamin, Rehan Quadri, Daniel Lamus, Anil Pillai
{"title":"Acute pulmonary embolism treatment in lung transplant recipients: mechanical thrombectomy and catheter directed thrombolysis.","authors":"Ahmad Arar, Samuel L Rice, Mhd Wisam Alnablsi, Akhilesh Pillai, Jamaal Benjamin, Rehan Quadri, Daniel Lamus, Anil Pillai","doi":"10.1186/s42155-024-00512-z","DOIUrl":"10.1186/s42155-024-00512-z","url":null,"abstract":"<p><strong>Purpose: </strong>Acute pulmonary embolism (PE) presents a significant challenge in lung transplant recipients (LTR), even with prophylactic anticoagulation. Due to the heightened risk of complications in this population, the optimal treatment approach for acute PE remains uncertain. This retrospective case series aims to elucidate the outcomes of percutaneous mechanical thrombectomy with the Inari device (MT) and catheter-directed thrombolysis (CDT) in managing acute PE in lung transplant patients.</p><p><strong>Materials and methods: </strong>This study examines the treatment outcomes of nine consecutive post-lung transplantation patients with acute PE confirmed with Computed Tomography Angiography (CTA). Treatment interventions included either MT or CDT. Follow-up assessments encompassed a minimum of one year and up to 3 years post-treatment, evaluating various parameters including ICU stay, ventricular pressures, pulmonary function, and laboratory tests.</p><p><strong>Results: </strong>Both MT and CDT achieved a 100% technical success rate, leading to the successful restoration of pulmonary blood flow and improvements in hemodynamic parameters, with a one-year survival rate of 100%.</p><p><strong>Conclusion: </strong>Percutaneous treatments, including MT and CDT, demonstrate feasibility and efficacy in managing acute PE among lung transplant patients. These treatments lead to rapid thrombus resolution, post-treatment improvements, and enhanced overall survival.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"19"},"PeriodicalIF":1.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11896909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-03DOI: 10.1186/s42155-025-00529-y
Tatjana Dell, Marilia B Voigt, Alexander Isaak, Alexander Boehner, Claus Pieper, Narine Mesropyan, Patrick Kupczyk, Julian Luetkens, Daniel Kuetting
{"title":"Impact of robotic assistance on the learning curve in endovascular interventions: exploring the role of operator experience with the CorPath GRX system.","authors":"Tatjana Dell, Marilia B Voigt, Alexander Isaak, Alexander Boehner, Claus Pieper, Narine Mesropyan, Patrick Kupczyk, Julian Luetkens, Daniel Kuetting","doi":"10.1186/s42155-025-00529-y","DOIUrl":"10.1186/s42155-025-00529-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigates how endovascular interventionalists adapt to using a robotic platform, specifically the CorPath GRX Robotic System, and examines the influence of prior manual catheterization experience.</p><p><strong>Materials and methods: </strong>An in-vitro trial was conducted to assess the adaptation to robot-assisted catheter-guided interventions in comparison to manual catheterization using a neurovascular phantom. Three interventional radiologists (beginner: no manual experience; intermediate: 3 years; expert: 10 years) with varying experience levels performed three corresponding robotic and manual guided superselective catherization tasks with three attempts per position with both approaches. Procedure time and total radiation dose was recorded.</p><p><strong>Results: </strong>For the beginner reduced intervention times were noted using the robot-assisted approach (mean: 123 s) in comparison to manual catheterization (mean: 257 s; p = 0.008), whilst no differences were seen in between procedure durations for the intermediate (mean: 71 s for manual versus 102 s for robotic; p = 0.388) and expert interventionalist (mean: 30 s for manual versus 42 s for robotic; p = 0.479). The beginner also benefited significantly from robot-assisted procedures with lower emitted total radiation doses (mean: 0.007 Gy for manual versus 0.003 Gy for robotic; p = 0.007), while no significant differences are observed for intermediate (mean: 0.002 Gy for manual versus 0.003 Gy for robotic; p = 0.137) and expert practitioners (mean: 0.0008 Gy for manual versus 0.001 Gy for robotic; p = 0.459).</p><p><strong>Conclusion: </strong>Robot-assisted platforms accelerate skill acquisition for beginners while maintaining efficiency for experienced practitioners. However, addressing costs and training requirements is essential for wider adoption and optimized outcomes.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"18"},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-03-03DOI: 10.1186/s42155-025-00532-3
Senta Frol, Faysal Benali, Aymeric Rouchaud, Robrecht R M M Knapen, Wim H van Zwam
{"title":"The variable use of heparin through intravenous bolus and flush fluid systems during endovascular stroke treatment, a world-wide survey.","authors":"Senta Frol, Faysal Benali, Aymeric Rouchaud, Robrecht R M M Knapen, Wim H van Zwam","doi":"10.1186/s42155-025-00532-3","DOIUrl":"10.1186/s42155-025-00532-3","url":null,"abstract":"<p><strong>Background: </strong>The total amount of heparin administered through flush fluids in stroke patients is not considered in recent trials, possibly influencing main results. We investigated the use of heparin among treating physicians worldwide.</p><p><strong>Methods: </strong>We conducted a survey from November 2022 to January 2023 to identify the variability of heparin administration during stroke endovascular treatment (EVT). We calculated the total heparin dose per hour (IU/h) by adding the intravenous (IV)-bolus dose to the amount administered through flush fluids, calculated by a multiplication of the number of infusion bags, drip rate[mL/h] and heparin concentration[IU/L].</p><p><strong>Results: </strong>A total of 315 participants from different countries worldwide completed the survey and 231/315(73%) respondents administer heparin during EVT. The majority administered heparin only through flush fluids (168/231; 72.7%), followed by both IV-bolus and flush fluids (36/231; 16%), and those who used only an IV-bolus (27/231; 11.7%). From the participants that administer heparin through flush fluids, the median heparin concentration was 2000 IU/L (range:100 IU/L-10000 IU/L). The total heparin dose (administered through flush fluids and IV-bolus) among 23 respondents showed a median of 4650 IU/h (IQR:3432-5900). Among the respondents who administer heparin through IV-bolus only, the median was 5250 IU (IQR:3750-7500).</p><p><strong>Conclusion: </strong>This survey revealed variable heparin doses administered by physicians worldwide during EVT and reflects the lack of international guidelines. Caution is warranted, specifically during complex/long EVT procedures. Furthermore, heparin flush doses should be considered in future trials regarding periprocedural anticoagulants, since imbalances could potentially confound results.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"17"},"PeriodicalIF":1.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CVIR EndovascularPub Date : 2025-02-27DOI: 10.1186/s42155-025-00530-5
Stavros Spiliopoulos, Lazaros Reppas, Nikolaos Giannikas, Panagiotis Kitrou, Michail Theofanis, Michail Karpetas, Anargyros N Moulas, Ioannis Paraskevopoulos, Amalia I Moula, Kechagias Ioannis, Dimitrios Karnabatidis
{"title":"Evaluation of a new Everolimus-coated balloon catheter in an in-vivo porcine peripheral venous model.","authors":"Stavros Spiliopoulos, Lazaros Reppas, Nikolaos Giannikas, Panagiotis Kitrou, Michail Theofanis, Michail Karpetas, Anargyros N Moulas, Ioannis Paraskevopoulos, Amalia I Moula, Kechagias Ioannis, Dimitrios Karnabatidis","doi":"10.1186/s42155-025-00530-5","DOIUrl":"10.1186/s42155-025-00530-5","url":null,"abstract":"<p><strong>Background: </strong>The venous uptake following the application of Everolimus-coated balloons is under reported. We evaluated the feasibility, safety, and Everolimus (EVR) deliverability of a novel non-commercially available Everolimus-Coated Balloon (ECB) catheter in a swine healthy peripheral vein model.</p><p><strong>Methods: </strong>In total 12 ECBs (5.0 μg/mm<sup>2</sup>) were inflated in 12 venous segments. The primary feasibility endpoint was the successful application of the ECB at the target venous sites. The primary efficacy endpoint was the successful drug uptake by the target venous tissue at 24 h and 7 days, assessed by High Performance Liquid Chromatography combined with tandem mass spectrometry. The primary safety endpoint was freedom from major adverse events.</p><p><strong>Results: </strong>Everolimus was detected in 10 out of 12 (83.33%) tissue samples (all six tissue samples at 24 h post-intervention and in four out of six samples at 7 days). The mean weight of the examined tissue was 0.20604 ± 0.29822 g (range: 0.37475-0.02229 g). The average EVR tissue content detected at 24 h (135.67 ± 204.95 μg/g) was numerically superior, but non-statistically significant to the that detected 7 days post-procedure (96.85 ± 110.89 μg/g). The average quantity of EVR on the balloon after retrieval was 33.9% of the initial drug dose. No adverse events were recorded, and no abnormalities were noted during autopsy.</p><p><strong>Conclusions: </strong>The newly developed ECB successfully delivered Everolimus within the healthy venous wall. No adverse events were noted at a short-term follow-up.</p><p><strong>Relevance statement: </strong>These safety and feasibility results justify further experimental and clinical research to demonstrate the safety efficacy the specific balloon catheter.</p>","PeriodicalId":52351,"journal":{"name":"CVIR Endovascular","volume":"8 1","pages":"16"},"PeriodicalIF":1.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}