Efficacy of the Preloading Coil-In-Plug Method for Internal Iliac Artery Embolization

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Endovascular Repair

Background:

• Embolization of the internal iliac artery (IIA) is sometimes required during endovascular aneurysm repair (EVAR).
• The preloading coil-in-plug (P-CIP) technique facilitates high-density embolization in confined spaces.
• This study retrospectively evaluated the P-CIP technique against conventional coil embolization (CE).

Purpose of the Study:

• To assess the efficacy of the P-CIP technique for IIA embolization.
• To compare the P-CIP technique with conventional coil embolization (CE).

Main Methods:

• Retrospective analysis of 56 patients undergoing IIA embolization between January 2015 and December 2023.
• Patients were divided into P-CIP (25 patients) and CE (31 patients) groups.
• Exclusion criteria included embolization with only an Amplatzer vascular plug or P-CIP using AVP2.

Main Results:

• No significant differences in embolization vessel diameter, procedure time, or type 2 endoleak incidence.
• P-CIP group used fewer coils (3.36 vs 4.30) and achieved a higher complete occlusion rate (76.0% vs 32.3%).
• P-CIP demonstrated a smaller embolization range (20.1 mm vs 31.7 mm) with comparable buttock claudication incidence (52.0% vs 41.9%).

Conclusions:

• The P-CIP technique provides effective and reliable embolization of the IIA trunk.
• P-CIP shows significant advantages over conventional CE in terms of coil usage and occlusion rates.
• Full recovery from buttock claudication was observed in all patients within one year postoperatively.