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Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device

BACKGROUND: We investigated the feasibility of aneurysm sac embolization using a novel self-expanding porous shape memory polymer (SMP) device during endovascular aortic abdominal or thoracic aneurysm repair (EVAR). METHODS: Retrospective analysis of consecutive patients treated at 2 centers in Germ...

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Autores principales: Massmann, Alexander, Fries, Peter, Shayesteh-Kheslat, Roushanak, Buecker, Arno, Berg, Patrick, Frenzel, Felix
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068687/
https://www.ncbi.nlm.nih.gov/pubmed/37009937
http://dx.doi.org/10.1186/s41747-023-00328-x
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author Massmann, Alexander
Fries, Peter
Shayesteh-Kheslat, Roushanak
Buecker, Arno
Berg, Patrick
Frenzel, Felix
author_facet Massmann, Alexander
Fries, Peter
Shayesteh-Kheslat, Roushanak
Buecker, Arno
Berg, Patrick
Frenzel, Felix
author_sort Massmann, Alexander
collection PubMed
description BACKGROUND: We investigated the feasibility of aneurysm sac embolization using a novel self-expanding porous shape memory polymer (SMP) device during endovascular aortic abdominal or thoracic aneurysm repair (EVAR). METHODS: Retrospective analysis of consecutive patients treated at 2 centers in Germany. Patients were treated from January 2019 to July 2021 with follow-up at 7 days and 3, 6, and 12 months. Aneurysm sacs were implanted with SMP devices immediately following endograft placement during the same procedure. Primary endpoint was technically successful SMP-device deployment into the aneurysm sac outside the endograft. Secondary endpoints were changes in aneurysm volume and associated complications (e.g., endoleaks). RESULTS: We included 18 patients (16 males), aged 72 ± 9 years, achieving 100% technical success. Mean preprocedure aortic aneurysm sac volume was 195 ± 117 mL with a perfused aneurysm volume of 97 ± 60 mL. A mean of 24 ± 12 SMP devices per patient were used (range 5–45, corresponding to 6.25–56.25 mL expanded embolic material volume). All evaluable patients exhibited sac regression except 2 patients yet to reach 3-month follow-up. At mean 11 ± 7 months (range 3–24), change in aneurysm volume from baseline was -30 ± 21 mL (p < 0.001). In 8 patients, aneurysm regression was observed despite type 2 endoleaks in 6 and type 1A endoleaks in 2, none of them requiring further intervention to date. No morbidity or mortality related to this treatment occurred. CONCLUSIONS: SMP devices for aortic aneurysm sac embolization during endovascular repair appear feasible and safe in this small case series. Prospective studies are needed. KEY POINTS: • Shape memory polymer is a novel, self-expanding, porous, and radiolucent embolic device material. • Aortic aneurysm sacs were treated with polymer devices immediately following endograft placement. • Aortic aneurysm sac regression was observed in all patients with over 3-month follow-up. • Aortic aneurysm sac regression was observed even in the presence of endoleaks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41747-023-00328-x.
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spelling pubmed-100686872023-04-04 Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device Massmann, Alexander Fries, Peter Shayesteh-Kheslat, Roushanak Buecker, Arno Berg, Patrick Frenzel, Felix Eur Radiol Exp Original Article BACKGROUND: We investigated the feasibility of aneurysm sac embolization using a novel self-expanding porous shape memory polymer (SMP) device during endovascular aortic abdominal or thoracic aneurysm repair (EVAR). METHODS: Retrospective analysis of consecutive patients treated at 2 centers in Germany. Patients were treated from January 2019 to July 2021 with follow-up at 7 days and 3, 6, and 12 months. Aneurysm sacs were implanted with SMP devices immediately following endograft placement during the same procedure. Primary endpoint was technically successful SMP-device deployment into the aneurysm sac outside the endograft. Secondary endpoints were changes in aneurysm volume and associated complications (e.g., endoleaks). RESULTS: We included 18 patients (16 males), aged 72 ± 9 years, achieving 100% technical success. Mean preprocedure aortic aneurysm sac volume was 195 ± 117 mL with a perfused aneurysm volume of 97 ± 60 mL. A mean of 24 ± 12 SMP devices per patient were used (range 5–45, corresponding to 6.25–56.25 mL expanded embolic material volume). All evaluable patients exhibited sac regression except 2 patients yet to reach 3-month follow-up. At mean 11 ± 7 months (range 3–24), change in aneurysm volume from baseline was -30 ± 21 mL (p < 0.001). In 8 patients, aneurysm regression was observed despite type 2 endoleaks in 6 and type 1A endoleaks in 2, none of them requiring further intervention to date. No morbidity or mortality related to this treatment occurred. CONCLUSIONS: SMP devices for aortic aneurysm sac embolization during endovascular repair appear feasible and safe in this small case series. Prospective studies are needed. KEY POINTS: • Shape memory polymer is a novel, self-expanding, porous, and radiolucent embolic device material. • Aortic aneurysm sacs were treated with polymer devices immediately following endograft placement. • Aortic aneurysm sac regression was observed in all patients with over 3-month follow-up. • Aortic aneurysm sac regression was observed even in the presence of endoleaks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41747-023-00328-x. Springer Vienna 2023-04-03 /pmc/articles/PMC10068687/ /pubmed/37009937 http://dx.doi.org/10.1186/s41747-023-00328-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Massmann, Alexander
Fries, Peter
Shayesteh-Kheslat, Roushanak
Buecker, Arno
Berg, Patrick
Frenzel, Felix
Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title_full Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title_fullStr Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title_full_unstemmed Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title_short Feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
title_sort feasibility of aortic aneurysm sac embolization using a novel shape memory polymer embolic device
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10068687/
https://www.ncbi.nlm.nih.gov/pubmed/37009937
http://dx.doi.org/10.1186/s41747-023-00328-x
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