Protective embolization of the gastroduodenal artery with a one-HydroCoil technique in radioembolization procedures

Protective occlusion of the gastroduodenal artery (GDA) is required to avoid severe adverse effects and complications in radioembolization procedures. Because of the expandable features of HydroCoils, our goal was to occlude the GDA with only one HydroCoil to provide particle reflux protection.

Twenty-three subjects with unresectable liver tumors, who were scheduled for protective occlusion of the GDA before radioembolization therapy, were included. The primary end point was to achieve a proximal occlusion of the GDA with only one detachable HydroCoil. Evaluated parameters were duration of deployment, and early (during the intervention) and late (7-21 days) occlusion rates of GDA. Secondary end points included complete duration of the intervention, amount of contrast medium used, fluoroscopy rates, and adverse effects.

In all cases, the GDA was successfully occluded with only one HydroCoil. The selected diameter/length range was 4/10 mm in 2 patients, 4/15 mm in 6 patients, and 4/20 mm in 15 patients. HydroCoils were implanted, on average, 3.75 mm from the origin of the GDA (range 1.5-6.8 mm), with an average deployment time of 2:47 (median 2:42, range 2:30-3:07) min. In 21 (91%) of 23 patients, a complete occlusion of the GDA was achieved during the first 30 min after the coil implantation; however, in all patients, a late occlusion of the GDA was present after 6 to 29 days. No clinical or technical complications were reported.

We demonstrated that occlusion of the GDA with a single HydroCoil is a safe procedure and successfully prevents extrahepatic embolization before radioembolization.