Prospective Comparison of Hydrogel-coated Microcoils versus Fibered Platinum Microcoils in the Prophylactic Embolization of the Gastroduodenal Artery before Yttrium-90 Radioembolization

• Published in: Journal of vascular and interventional radiology Vol. 24; no. 6; pp. 797 - 803
• Main Authors: Maleux, Geert, MD, PhD, Deroose, Christophe, MD, PhD, Fieuws, Steffen, MSc, PhD, Van Cutsem, Eric, MD, PhD, Heye, Sam, MD, PhD, Bosmans, Hilde, MSc, PhD, Verslype, Chris, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2013
• Subjects: Brachytherapy - methods; Catheterization, Peripheral - instrumentation; Catheterization, Peripheral - methods; Coated Materials, Biocompatible - chemistry; Combined Modality Therapy - methods; Embolization, Therapeutic - instrumentation; Equipment Failure Analysis; Humans; Hydrogels - chemistry; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Miniaturization; Platinum - chemistry; Prospective Studies; Prosthesis Design; Radiography; Radiology; Treatment Outcome; Yttrium Radioisotopes - therapeutic use; DAP; gastroduodenal artery; selective internal radiation therapy; dose–area product; GDA; SIRT
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2013.01.503

Abstract Purpose To prospectively assess the performance of hydrogel-coated versus fibered microcoils in the prophylactic occlusion of the gastroduodenal artery (GDA) before yttrium-90 (90 Y) radioembolization. Materials and Methods A total of 43 patients were randomized to receive fibered microcoils (n = 15), detachable hydrogel-coated microcoils (n = 13), or pushable hydrogel-coated microcoils (n = 15). Numbers of coils used, duration, dose–area product (DAP), contrast agent load, and coil migration were assessed. At the time of yttrium-90 (90 Y) radioembolization, persistent GDA occlusion was analyzed. Results In all patients, the embolized GDA was still completely occluded at the time of90 Y radioembolization. Mean numbers of microcoils used per patient were 11.5 (fibered microcoils), 2.9 (detachable hydrocoils), and 5.5 (pushable hydrocoils), with all numbers significantly different ( P <.0001). Mean DAPs were 16,283 mGy/cm2 ±16,545 (standard deviation) for fibered microcoils, 13,786 mGy/cm2 ±5,990 for detachable hydrocoils, and 35,757 mGy/cm2 ±74,493 for pushable hydrocoils ( P = .87). Mean durations of GDA coil embolization were 20 minutes for fibered microcoils, 25 minutes for detachable hydrocoils, and 32 minutes for pushable hydrocoils ( P = .0015). Mean contrast agent loads were 9 mL for fibered microcoils, 11 mL for pushable hydrocoils, and 7 mL for detachable hydrocoils ( P = .13). One case of coil migration occurred with each type. Conclusions Hydrogel-coated and fibered microcoils are equally effective for prophylactic occlusion of the GDA before radioembolization. The number of coils used is higher with fibered microcoils compared with pushable and detachable hydrocoils, but the reduced number of hydrocoils comes at the cost of increased procedure duration.