Clinical Outcomes of Arteriovenous Fistula Treatment Using the Penumbra SMART COIL System: A Subgroup Analysis from the Multicenter SMART Registry.

Arteriovenous fistula carotid-cavernous sinus fistula coils embolization endovascular procedures therapeutic treatment outcomes

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
08 Jul 2024
Historique:
received: 28 05 2024
accepted: 03 07 2024
medline: 11 7 2024
pubmed: 11 7 2024
entrez: 10 7 2024
Statut: aheadofprint

Résumé

Endovascular embolization procedures are typically the primary treatment modality for arteriovenous fistula (AVF). The objective of this subset analysis was to evaluate the prospective long-term clinical outcomes of AVF patients treated with the SMART COIL System. Patients who had arteriovenous fistulas (AVF) and underwent endovascular coiling using the Penumbra SMART COIL system were part of a subset analysis within the SMART registry. The SMART registry is a post-market registry that is prospective, multicenter, and single-arm in design. After the treatment, these patients were monitored for a period of 12 ± 6 months. A total of 41 patients were included. No patients (0/41) had a procedural device-related serious adverse event (SAE). Re-access involving a guidewire due to catheter kickout was unnecessary for 85.4% (35/41) of the patients. Complete occlusion after the procedure was achieved in 87.8% (36/41) of patients. The periprocedural SAE rate was 2.4% (1/41), and no periprocedural deaths occurred (0/41). During the follow-up period, there were instances of re-treatment in 3.4% (1/29) of patients. At one year, the lesion occlusion was better or stable in 93.3% (28/30) of patients. The rate of serious adverse events (SAE) from 24 hours to 1 year (±6 months) following the procedure was 26.8% (11/41). The one-year all-cause mortality rate stood at 2.4% (1/ 41), and at the one-year follow-up, 90.9% (20/22) of patients had a modified Rankin Scale score within the range of 0 to 2. The coiling procedure for arteriovenous fistulas using the SMART COIL System proved to be safe and effective at the one-year follow-up.

Sections du résumé

BACKGROUND BACKGROUND
Endovascular embolization procedures are typically the primary treatment modality for arteriovenous fistula (AVF). The objective of this subset analysis was to evaluate the prospective long-term clinical outcomes of AVF patients treated with the SMART COIL System.
METHODS METHODS
Patients who had arteriovenous fistulas (AVF) and underwent endovascular coiling using the Penumbra SMART COIL system were part of a subset analysis within the SMART registry. The SMART registry is a post-market registry that is prospective, multicenter, and single-arm in design. After the treatment, these patients were monitored for a period of 12 ± 6 months.
RESULTS RESULTS
A total of 41 patients were included. No patients (0/41) had a procedural device-related serious adverse event (SAE). Re-access involving a guidewire due to catheter kickout was unnecessary for 85.4% (35/41) of the patients. Complete occlusion after the procedure was achieved in 87.8% (36/41) of patients. The periprocedural SAE rate was 2.4% (1/41), and no periprocedural deaths occurred (0/41). During the follow-up period, there were instances of re-treatment in 3.4% (1/29) of patients. At one year, the lesion occlusion was better or stable in 93.3% (28/30) of patients. The rate of serious adverse events (SAE) from 24 hours to 1 year (±6 months) following the procedure was 26.8% (11/41). The one-year all-cause mortality rate stood at 2.4% (1/ 41), and at the one-year follow-up, 90.9% (20/22) of patients had a modified Rankin Scale score within the range of 0 to 2.
CONCLUSION CONCLUSIONS
The coiling procedure for arteriovenous fistulas using the SMART COIL System proved to be safe and effective at the one-year follow-up.

Identifiants

pubmed: 38986948
pii: S1878-8750(24)01151-3
doi: 10.1016/j.wneu.2024.07.012
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Ahmed Abdelsalam (A)

University of Miami, Department of Neurological Surgery, Miami, FL, USA. Electronic address: aaa824@miami.edu.

Michael Silva (M)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Min S Park (MS)

University of Virginia, Department of Neurological Surgery, Charlottesville, VA, USA.

Tiffany Eatz (T)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Clemens M Schirmer (CM)

Geisinger Commonwealth School of Medicine, Department of Neurosurgery, Wilkes-Barre, PA, USA.

Sai Sanikommu (S)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Eva M Wu (EM)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Richard J Bellon (RJ)

Swedish Medical Center, Department of Radiology, Englewood, CO, USA.

Joshua D Burks (JD)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Alejandro M Spiotta (AM)

Medical University of South Carolina, Department of Neurosurgery, Charleston, SC, USA.

Robert M Starke (RM)

University of Miami, Department of Neurological Surgery, Miami, FL, USA.

Classifications MeSH