Plug-Based Embolization Techniques of Aortic Side Branches during Standard and Complex Endovascular Aortic Repair

Area of Science:

• Endovascular Surgery
• Interventional Radiology
• Vascular Medicine

Background:

• Vascular plugs are advanced vessel occluders for large, high-flow arteries.
• Available in Nitinol mesh and polytetrafluoroethylene (PTFE) membrane designs, they treat arteries from 3 to 20 mm.
• They are increasingly used in complex endovascular aortic procedures.

Purpose of the Study:

• To review current techniques and technologies for vascular plug embolization.
• To highlight applications in complex endovascular aortic repair.
• To compare plug embolization with traditional coil embolization.

Main Methods:

• Narrative review of up-to-date literature on vascular plug technology.
• Analysis of plug applications in aortic branch embolization, endoleak prevention, and false lumen embolization.
• Comparison of technical and clinical outcomes with coil embolization.

Main Results:

• Vascular plugs provide a single-device embolization system for large arteries.
• They are effective in preventing endoleak, enabling landing zones, and managing aortic dissection.
• Plugs offer advantages over coils, including repositionability, lower migration rates, and fewer imaging artifacts, despite larger delivery systems.

Conclusions:

• Vascular plugs are a valuable and evolving tool in endovascular aortic repair.
• They offer enhanced accuracy and safety compared to traditional methods.
• Further research may focus on optimizing delivery systems for these effective occluders.