The nitinol vascular occlusion plug: preliminary experimental evaluation in peripheral veins

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Biomaterials Science

Background:

• Peripheral venous occlusion is crucial for managing various vascular conditions.
• Traditional methods like stainless steel coils have limitations, including recanalization and migration.
• Novel devices are needed to improve occlusion efficacy and reduce complications.

Purpose of the Study:

• To compare the efficacy of a nitinol occlusion plug against standard stainless steel coils.
• To evaluate occlusion time, recanalization, and migration rates in moderate-size peripheral veins.

Main Methods:

• A nitinol plug, a self-expanding braided device with polyester fibers, was tested.
• Ten occlusion procedures were performed in five dogs using a retrograde transjugular venous approach.
• Nitinol plugs and Gianturco coils were deployed in femoropopliteal veins, with follow-up venography and explantation at 1 month.

Main Results:

• Nitinol plugs achieved significantly faster occlusion times (4.2 minutes) versus coils (25.6 minutes).
• At 1 month, only 20% of nitinol occluders showed recanalization or migration, compared to 80% of coil-doublets.
• Histopathology revealed organized matrix and intimal proliferation in nitinol-occluded veins.

Conclusions:

• A single nitinol occluder is superior to two Gianturco coils for achieving rapid and durable occlusion in moderate peripheral veins.
• The nitinol plug demonstrates a significantly lower rate of recanalization and migration.
• This device represents a potentially more effective solution for peripheral venous occlusion.