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Giurazza F, Ierardi A, Marra P, Lucatelli P, Corvino F, Pane F, Sironi S, Carrafiello G, Loffroy R, Niola R. Pseudoaneurysms embolization with glue via percutaneous direct puncture: a multicenter experience on 54 patients. CVIR Endovasc 2024; 7:11. [PMID: 38221592 PMCID: PMC10788324 DOI: 10.1186/s42155-024-00426-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024] Open
Abstract
BACKGROUND This retrospective multicentric study aims to report on technical safety and effectiveness of pseudoaneurysms embolization with glue (N-butyl cyanoacrylate) adopting a percutaneous direct puncture approach. RESULTS Fifty-four patients data were collected from five centers. All patients at the time of treatment presented with unruptured PAs and were hemodynamically stable. True aneurysms and lesions treated with embolics other than glue were excluded. Pseudoaneurysms diagnosis was based on CT and anamnestic data; initial investigation with digital-subtracted arteriography was acquired in all cases; then, percutaneous embolizations were performed in the angio-suite (ultrasound, fluoroscopy, ConeBeam CT guidance) or in CT. Technical success was considered as complete pseudoaneurysm embolization at final imaging with sole percutaneous strategy, without need for additional endovascular embolization. Clinical success was intended as pseudoaneurysm resolution within one week follow-up with stabilization or restored clinical conditions. Pseudoaneurysms origins were traumatic (57.4%), inflammatory (24.1%) or spontaneous (18.5%); 39 patients (72.2%) were symptomatic, presenting with pain and/or pulsatile mass. Mean lesions diameter was 19.3 mm (range: 7-30); pseudoaneurysms were located in abdomen (48.1%), limbs (42.6%) and thorax (9.3%). Coagulation function was impaired in 16.6% and 48.1% was under antiplatelets/anticoagulation therapy. In 16.6% the percutaneous approach followed previous treatments failure. The image-guidance modality for percutaneous puncture was most often ultrasound combined with fluoroscopy (38%). Clinical success was obtained in all patients while technical success occurred in 94.4% because 3 patients required an additional endovascular embolization. Complications were registered in 14.8%, all of low grade without clinical sequelae neither prolonged recovery (7 non target embolizations, 1 post-embolization syndrome). CONCLUSIONS In this study, pseudoaneurysms embolization with glue via percutaneous direct puncture was safe and effective with a low rate of minor complications.
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Affiliation(s)
- Francesco Giurazza
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy.
| | - Annamaria Ierardi
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
| | - Paolo Marra
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, University of Milano Bicocca, Piazza OMS 1, Bergamo, 24127, Italy
| | - Pierleone Lucatelli
- Vascular and Interventional Radiology Unit, Department of Radiological, Oncological, and Anatomo-Pathological Sciences, Sapienza University of Rome, Roma, 00161, Italy
| | - Fabio Corvino
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | - Francesco Pane
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII Hospital, University of Milano Bicocca, Piazza OMS 1, Bergamo, 24127, Italy
| | - Gianpaolo Carrafiello
- Radiology Department, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, 20122, Italy
- Department of Health Sciences, Università degli Studi di Milano, Via F. Sforza 35, Milan, 20122, Italy
| | - Romaric Loffroy
- Image-Guided Therapy Center, ICMUB Laboratory, Department of Vascular and Interventional Radiology, François-Mitterrand University Hospital, BP 77908, 14 Rue Paul Gaffarel, Dijon, 21079, France
| | - Raffaella Niola
- Vascular and Interventional Radiology Department, Cardarelli Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
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