Usefulness of Amplatzer Vascular Plug for Preoperative Embolization Before Distal Pancreatectomy with En Bloc Celiac Axis Resection

Cardiovasc Intervent Radiol. 2019 Sep;42(9):1352-1357. doi: 10.1007/s00270-019-02233-6. Epub 2019 May 10.

Abstract

Purpose: We evaluated the usefulness of the Amplatzer vascular plug (AVP) for preoperative embolization before distal pancreatectomy with en bloc celiac axis resection (DP-CAR).

Materials and methods: Between April 2010 and September 2017, 19 patients with locally advanced pancreatic body cancer underwent preoperative embolization of the common hepatic and the left gastric artery (CHA, LGA) with AVP or coils. We compared the embolization success rate, embolization-related complications, the time required for preoperative embolization before DP-CAR and the procedure costs in patients whose CHA was AVP- (n = 7) or coil (n = 12) embolized.

Results: The success rate for preoperative AVP and coil embolization was 100% and 83.3%, respectively. The median procedure time was shorter in patients whose CHA was embolized with AVP than coils; the difference was not significant (p = 0.045). The total cost was significantly lower for AVP than coil embolization (p = 0.01).

Conclusion: The AVP is useful for the preoperative embolization of the CHA before DP-CAR.

Keywords: Amplatzer vascular plug; Coil; Distal pancreatectomy with en bloc celiac axis resection; Embolization; Pancreatic cancer.

MeSH terms

  • Aged
  • Celiac Artery / surgery*
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods*
  • Female
  • Gastric Artery / diagnostic imaging
  • Gastric Artery / surgery
  • Hepatic Artery / diagnostic imaging
  • Hepatic Artery / surgery
  • Humans
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Pancreas / surgery
  • Pancreatectomy*
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / surgery*
  • Preoperative Care / methods*
  • Radiography
  • Septal Occluder Device