Case series of 3 patients undergoing embolization of splenic artery aneurysms. The procedure involved the use of coils and n-butyl 2-cyanoacrylate (NBCA), and a newly developed polytetrafluoroethylene (PTFE)-coated microcatheter.

Case series of 3 patients undergoing embolization of splenic artery aneurysms. The procedure involved the use of coils and n-butyl 2-cyanoacrylate (NBCA), and a newly developed polytetrafluoroethylene (PTFE)-coated microcatheter.

A new approach to the embolization of splenic artery aneurysms (SAA) has shown promising results, according to a recent retrospective case series. The study, which focused on the utility and outcomes of treating SAA using a combination of coils and NBCA (N-butyl cyanoacrylate) delivered via the Carry Leon NSX microcatheter, has highlighted several advantages and potential challenges.

Advantages of PTFE-Coated Microcatheter

The PTFE (polytetrafluoroethylene) coating on the Carry Leon NSX microcatheter offers several notable benefits.

1. Reduced Adhesion and Catheter Stickiness: The low-friction surface provided by the PTFE coating reduces the risk of the microcatheter adhering to NBCA glue during embolization, preventing catheter entrapment and ensuring safe withdrawal after glue deployment.
2. Improved Navigability and Trackability: The smooth, lubricious PTFE coating enhances the catheter’s ability to navigate tortuous or small-caliber vessels like the splenic artery branches, enabling more precise positioning near the aneurysm.
3. Durability and Resistance to Chemical Interaction: PTFE coatings are chemically inert, resisting degradation or damage from NBCA or contrast media, thus maintaining catheter integrity throughout the procedure.
4. Facilitates Combination Embolization: Using coils in conjunction with NBCA can improve occlusion efficacy. A PTFE-coated microcatheter allows controlled delivery of both embolic materials in a sequential or combined manner.

Potential Challenges

While the PTFE-coated microcatheter offers numerous advantages, it also presents some potential challenges:

1. Potential Cost and Availability: Specialized PTFE-coated microcatheters may be more expensive or less readily available compared to standard catheters.
2. Risk of Glue Reflux: Despite reduced adhesion, NBCA polymerizes rapidly and may still reflux proximally, possibly causing non-target embolization. Operator skill and precise technique remain critical.
3. Limited Support for Large or Highly Tortuous Vessels: While improved, the microcatheter may still struggle in extremely tortuous or large vessels, potentially limiting its use in some anatomical variants.
4. Requirement for Experience: Handling NBCA with microcatheters requires experience to balance polymerization time and injection speed, to avoid catheter gluing or incomplete embolization.
5. Imaging and Visualization Limitations: Coated catheters might have slightly different radiopacity profiles, so visualization must be confirmed to ensure accurate deployment.

Case Studies

The study involved three female patients with SAA, aged between 55 and 80 years. Each patient underwent successful embolization via a triple coaxial system, resulting in complete aneurysm occlusion. During the embolization, one AVP4 plug migrated into the aneurysm sac, but a second AVP4 plug was used to successfully embolize the outflow vessel.

On admission, the patients presented with mild elevations in ALP levels, WBC count, CRP level, gamma-glutamyl transpeptidase (γGTP), and showed grade 3 renal dysfunction. However, minimal complications such as mild splenic infarction or transient inflammatory responses were observed, and each patient was discharged within three days. Follow-up MRI confirmed complete occlusion of the aneurysm with mild splenic infarction.

The SAA measured between 25 × 16 × 18 mm and 26 × 21 × 22 mm and were located near the splenic hilum. They had inflow vessels ranging from 6.7 mm to 8.4 mm, and outflow vessels measuring between 4.2 mm and 9.0 mm.

The use of a PTFE-coated NSX microcatheter can enhance the safety and efficacy of NBCA injections, making it a potential alternative embolization technique for SAA. However, procedural success relies heavily on operator expertise and careful technique to mitigate risks like glue reflux and catheter entrapment, in addition to balancing cost and anatomical considerations.

1. Science Continues to Advance: The field of medicine has once again demonstrated advancements, as a new approach to the embolization of splenic artery aneurysms using a PTFE-coated microcatheter has shown promising results.
2. Medical-Conditions and Treatment Options: This new approach could provide an additional treatment option for individuals suffering from splenic artery aneurysms, offering potentially less invasive and more effective courses of action.
3. Chronic Diseases and Long-term Health: Chronic diseases such as cardiovascular health issues can greatly benefit from advancements in medical technology, like the use of embolization techniques for aneurysms.
4. Financial Considerations and Healthcare Access: While specialized equipment may come with a higher cost, the potential benefits and improved patient outcomes might justify the investment in these cutting-edge medical tools.
5. Lifestyle Improvements and Long-term Health: Reduced recovery times and improved long-term health outcomes, enabled by advancements like the PTFE-coated microcatheter, can lead to enhanced quality of life for those affected by various medical conditions.
6. Investing in Healthcare Technologies: As society continues to evolve and prioritize healthcare, smart investments in innovative technologies like the PTFE-coated microcatheter could lead to breakthroughs in treating chronic diseases and improving cardiovascular health.
7. Smart Living and Home Improvements: The technological advancements in medicine have ripple effects, inspiring innovations in other sectors, such as home and garden products. With more resources being dedicated to healthcare, there may be increased investment in smart home devices and sustainable gardening tools.
8. Business Opportunities and Real-Estate: With the rise of technology-focused healthcare, businesses and real-estate developments catering to medical startups and research facilities may see increased demand.
9. Technological Intersections: As technology improves medical procedures like the embolization of splenic artery aneurysms, advancements in imaging, weather forecasting, and sports analysis may intersect, leading to exciting outcomes in various industries.
10. Travel and Adventure: The tourism industry could benefit from advancements in medical technology, as destinations offer specialized health services to attract visitors seeking cutting-edge treatments.
11. Auto Racing and Safety Measures: Advancements in sports technology can lead to enhanced safety measures, like improved helmet design and track monitoring, helping protect athletes in high-risk sports like auto racing.
12. Mixed Martial Arts and Performance Enhancement: In contact sports like mixed martial arts, advancements in sports technology could help develop protective equipment and accelerate recovery times, improving athlete performance and reducing injury risks.
13. Sports Betting and European Leagues: The integration of technology in sports might lead to new opportunities in the sports betting industry, such as real-time data and more accurate predictions for European leagues like the premier league, NBA, MLB, NHL, and golf tournaments.

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