Introduction: Microvascular Plug (MVP) system (Reverse Medical Corporation, Irvine, CA) is a self-expanding device made of nitinol and a polytetrafluoroethylene (PFTE) cover. MVP is detached by electrolytic means. It is indicated to obstruct blood flow in the peripheral vasculature and not intended for intracranial vessels at this time. This is the first device developed for parent vessel occlusion since detachable balloons were discontinued. Resection of hypervascular tumors can be hampered by hemorrhagic complications. Pre-operative embolization of hypervascular tumors of the head and neck, spinal tumors, and meningiomas is beneficial as long as the risk of the procedure is negligible.
Methods: From September 2013 to January 2014, a total of 6 patients underwent embolization of hypervascular tumors (3 memingiomas, 1 nasopharyngeal tumor, 2 spinal tumors) with Embospheres 100-300 microns, followed by deployment of MVP device into the parent feeding artery through 0.021 microcatheters.
Results: There was immediate complete obliteration of the parent vessel upon device deployment from the microcatheter. There were no failures of detachment. Five of the patients underwent resection of the embolized tumors one day after without complications. The intravascular device didn’t interfere with the resection as documented on Figure 1. Patient 6 (nasopharyngeal tumor) was determined to be high risk for surgery and was referred for radiation therapy. There were no immediate or delayed ischemic, hemorrhagic, or device related complications.
Conclusions: The MVP device for endovascular embolization of hypervascular tumors of the head and neck, spinal tumors and meningiomas is safe and effective. Given the safety profile and the ease of use, we believe that this device should be studied in the intracranial vasculature for parent vessel occlusion, aneurysm and AVM management. MVP is a safe and durable option of parent vessel occlusion, a first since detachable balloons were discontinued.
Patient Care: This research will benefit patients with hypervascular tumors of the head and neck, spinal tumors and meningiomas to decrease the risk of hemorrhagic complications during resection.
Learning Objectives: By the conclusion of this session, participants should be able to: 1)understand the benefits of pre-operative embolization of hypervascular tumors, 2)recognize the safety profile of the microvascular plug device for neuro-interventional embolization procedures.