E-086 EX vivo vascular model of human placenta to simulate the emolization of cerebral arteriovenous malformations with ONYX in a training program for neurointerventionists. (22nd July 2018)

• Record Type: Journal Article
• Authors: López, J; Vargas, O; Díaz, C; Torres, V; Serna, N; Pabon, B
• Is Part Of: Journal of neurointerventional surgery. Volume 10(2018)Supplement 2
• Page Start: A92
• Page End: A92
• Publication Date: 2018-07-22
• Subjects: Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2018-SNIS.162
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : The embolization of cerebral arterio-venous malformations (AVM´s) offers a challenge and demands ample skills on the part of the neurointerventionists. The human placenta represents an excellent option within training programs in neuroendovascular surgery. Purpose: To describe the utility of placental vessels as a model of cerebral AVMs for their embolization with Onyx embolic agent in a training program for neurointerventionists in Medellin, Colombia. Materials and methods: Two human placentas were prepared under an institutional protocol, from which the model of 6 AVM´s was obtained for embolization. Under fluoroscopy and Roadmap, a total of 10 different arterial pedicles were embolized with Onyx embolic agent at an injection rate of 0.3 ml/min. An injection rates of 0.7 ml/min were performed to intentionally evaluate the reflux behavior of the material embolism. The occlusion rates and the percentage of embolized arterial pedicles were documented. Secondarily, a survey was conducted with three neurointervencionistas with extensive experience in the embolization of AVM's to compare the behavior of the embolic material in the placental model against human models. Results: The percentage of embolized arterial pedicles was 100%. The expert neurointervencionistas indicated a high concordance of the behavior of the embolic material in the placental model and the human model. The human placenta has a blood vessel distribution that simulates the characteristics of the normal arterial tree and offers a distal vascular model that resembles an AVM. Due to its low cost and easy preparation, the placental vascular models reliably reproduce the behavior of the Onyx embolic agent and offer an excellent training opportunity for the development of skills by neurointerventionists. Disclosures: J. López: None. O. Vargas: None. C. Díaz: None. V. Torres: None. N. Serna: None. B. Pabon: None.