Double Balloon-Assisted Coil Embolization (BACE) Combined with Proximal and Distal Balloon Inflation for Short Abdominal Arterial Segments: Comparison with Single BACE.

PURPOSE: To evaluate the differences of technique between coil embolization for short abdominal arterial segments with only proximal balloon inflation and combined proximal and distal balloon inflation, as well as the volume embolization ratio (VER) and the ratio of the first coil diameter to the target vessel diameter (first coil diameter ratio).

MATERIALS AND METHODS: From January 2014 to August 2016, we performed coil embolization of the short segment in seven patients. The target vessels were the common hepatic arteries before distal pancreatectomy with en bloc celiac axis resection in five patients, the superior mesenteric artery for isolation of pseudoaneurysm in one patient and the celiac trunk for preventing Type II endoleak before endovascular aortic repair in one patient. We evaluate VER and first coil diameter ratio in single balloon-assisted coil embolization (BACE) with only proximal balloon inflation and double BACE with combined proximal and distal balloon inflation.

RESULTS: The BACE (single BACE; n = 4, double BACE; n = 3) was safely finished. The VER was median 12.1% (single BACE; mean 11.7%, double BACE; mean 12.4%). The first coil diameter ratio was median 1.82 in both groups.

CONCLUSION: The coil embolization was safely performed by BACE. Double BACE allowed planning of the distal end of the coil embolization site and the embolization segment prior to coil placement. We achieved sufficient friction to prevent coil migration by choosing detachable microcoils with a median diameter 1.82 times larger than that of the target vessel and a VER ≥12%, allowing us to embolize short vascular segments.