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Published in: CardioVascular and Interventional Radiology 1/2023

Open Access 30-11-2022 | Clinical Investigation

Results from the First-in-Human Study of the Caterpillar™ Arterial Embolization System

Authors: Andrew Holden, Bibombe P. Mwipatayi, Manar Khashram, Steven Dubenec, Gerard S. Goh, Richard A. Settlage

Published in: CardioVascular and Interventional Radiology | Issue 1/2023

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Abstract

Purpose

To assess occlusion success and adverse events associated with the use of a self-expanding device for peripheral artery embolization.

Methods

This prospective, single-arm, feasibility study was conducted using the Caterpillar™ Arterial Embolization Device composed of opposing nitinol fibers and a flow-occluding membrane. Twenty patients (24 embolization sites) were treated at four investigational centers in New Zealand and Australia and followed for 30 days. Embolization sites included mesenteric, accessory renal, and iliac arteries and their branches. Primary outcome measures were peri-procedural occlusion confirmed by angiography and freedom from device-related serious adverse events (SAEs) at 30 days. Secondary observations included time to occlusion and assessment of adverse events.

Results

Peri-procedural occlusion was 100%, and freedom from a device-related SAE was 94.7% at 30 days. One patient had abdominal bloating that required hospitalization deemed possibly related to the device or procedure. Twenty-two of 24 embolization sites were occluded with one device (91.7%). Mean procedure duration was 11.7 ± 8.6 min (device deployment time: 1.8 ± 1.0 min), and mean fluoroscopy time was 241 ± 290.7 s. All embolization sites occluded during the procedure with 62.5% occluded within three minutes and 91.6% occluded within ten minutes. No devices migrated or required re-embolization. Freedom from device- and procedure-related adverse events was 84.2%. One patient died from aortic rupture during a subsequent adjunctive abdominal aortic endovascular procedure deemed unrelated to the embolization device or procedure.

Conclusions

This first-in-human study of the Caterpillar embolization device achieved peri-procedural occlusion in all patients with a 94.7% freedom from device-related SAE at 30 days.

Level of Evidence

Level 2b—prospective, multicenter, single-arm, first-in-human clinical study. Pre-specified endpoints were analyzed using descriptive statistics.
Literature
1.
go back to reference Dariushnia SR, Redstone EA, Heran MKS, Cramer HR Jr, Ganguli S, Gomes AS, Hogan MJ, Himes EA, Patel S, Schiro BJ, Lewis CA. Society of interventional radiology quality improvement standards for percutaneous transcatheter embolization. J Vasc Interv Radiol. 2021;32(3):476.e1-476.e33. https://doi.org/10.1016/j.jvir.2020.10.022 (PMID: 33640083).CrossRef Dariushnia SR, Redstone EA, Heran MKS, Cramer HR Jr, Ganguli S, Gomes AS, Hogan MJ, Himes EA, Patel S, Schiro BJ, Lewis CA. Society of interventional radiology quality improvement standards for percutaneous transcatheter embolization. J Vasc Interv Radiol. 2021;32(3):476.e1-476.e33. https://​doi.​org/​10.​1016/​j.​jvir.​2020.​10.​022 (PMID: 33640083).CrossRef
2.
go back to reference Golzarian J, Sapoval MR, Kundu S, Hunter DW, Brountzos EN, Geschwind JF, Murphy TP, Spies JB, Wallace MJ, de Baere T, Cardella JF; Society of Interventional Radiology (SIR); Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Canadian Interventional Radiology Association (CIRA). Guidelines for Peripheral and Visceral Vascular Embolization Training: joint writing groups of the Standards of Practice Committees for the Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), and Canadian Interventional Radiology Association (CIRA). J Vasc Interv Radiol. 2010 Apr;21(4):436–41.https://doi.org/10.1016/j.jvir.2010.01.006. PMID: 20346881. Golzarian J, Sapoval MR, Kundu S, Hunter DW, Brountzos EN, Geschwind JF, Murphy TP, Spies JB, Wallace MJ, de Baere T, Cardella JF; Society of Interventional Radiology (SIR); Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Canadian Interventional Radiology Association (CIRA). Guidelines for Peripheral and Visceral Vascular Embolization Training: joint writing groups of the Standards of Practice Committees for the Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), and Canadian Interventional Radiology Association (CIRA). J Vasc Interv Radiol. 2010 Apr;21(4):436–41.https://​doi.​org/​10.​1016/​j.​jvir.​2010.​01.​006. PMID: 20346881.
9.
go back to reference Sue MJ, Luong TT, Park J, Ding P-X, Hao F, Eghbalieh N, Lee EW. A Multicenter, retrospective, matched, comparison study of clinical efficacy and cost-effectiveness of caterpillar arterial embolization device versus fibered coils in arterial embolization. Appl Sci. 2022;12(10):5262. https://doi.org/10.3390/app12105262.CrossRef Sue MJ, Luong TT, Park J, Ding P-X, Hao F, Eghbalieh N, Lee EW. A Multicenter, retrospective, matched, comparison study of clinical efficacy and cost-effectiveness of caterpillar arterial embolization device versus fibered coils in arterial embolization. Appl Sci. 2022;12(10):5262. https://​doi.​org/​10.​3390/​app12105262.CrossRef
12.
go back to reference Cynamon J, Lerer D, Veith FJ, Taragin BH, Wahl SI, Lautin JL, Ohki T, Sprayregen S. Hypogastric artery coil embolization prior to endoluminal repair of aneurysms and fistulas: buttock claudication, a recognized but possibly preventable complication. J Vasc Interv Radiol. 2000;11(5):573–7. https://doi.org/10.1016/s1051-0443(07)61608-x (PMID: 10834487).CrossRef Cynamon J, Lerer D, Veith FJ, Taragin BH, Wahl SI, Lautin JL, Ohki T, Sprayregen S. Hypogastric artery coil embolization prior to endoluminal repair of aneurysms and fistulas: buttock claudication, a recognized but possibly preventable complication. J Vasc Interv Radiol. 2000;11(5):573–7. https://​doi.​org/​10.​1016/​s1051-0443(07)61608-x (PMID: 10834487).CrossRef
16.
go back to reference Grenon SM, Gagnon J, Hsiang Y, Sidhu R, Taylor D, Clement J, Chen J. Occlusion of the common and internal iliac arteries for aortoiliac aneurysm repair: experience with the Amplatzer vascular plug. Can J Surg. 2009;52(6): E276–80. PMID: 20011164; PMCID: PMC2792393. Grenon SM, Gagnon J, Hsiang Y, Sidhu R, Taylor D, Clement J, Chen J. Occlusion of the common and internal iliac arteries for aortoiliac aneurysm repair: experience with the Amplatzer vascular plug. Can J Surg. 2009;52(6): E276–80. PMID: 20011164; PMCID: PMC2792393.
17.
18.
go back to reference Warein E, Feugier P, Chaufour X, Molin V, Malikov S, Bartoli MA, Coscas R, Picquet J, Peyrot H, Favre JP, Steinmetz E, Ben Ahmed S, Rosset E; AURC (Association Universitaire de Recherche en Chirurgie) – University Association for Research in Surgery. Amplatzer Plug to Occlude the Internal Iliac Artery During Endovascular Aortic Aneurysm Repair: A Large Multicenter Study. Eur J Vasc Endovasc Surg. 2016 May;51(5):641–6. https://doi.org/10.1016/j.ejvs.2015.12.021. Epub 2016 Feb 12. PMID: 26879098. Warein E, Feugier P, Chaufour X, Molin V, Malikov S, Bartoli MA, Coscas R, Picquet J, Peyrot H, Favre JP, Steinmetz E, Ben Ahmed S, Rosset E; AURC (Association Universitaire de Recherche en Chirurgie) – University Association for Research in Surgery. Amplatzer Plug to Occlude the Internal Iliac Artery During Endovascular Aortic Aneurysm Repair: A Large Multicenter Study. Eur J Vasc Endovasc Surg. 2016 May;51(5):641–6. https://​doi.​org/​10.​1016/​j.​ejvs.​2015.​12.​021. Epub 2016 Feb 12. PMID: 26879098.
Metadata
Title
Results from the First-in-Human Study of the Caterpillar™ Arterial Embolization System
Authors
Andrew Holden
Bibombe P. Mwipatayi
Manar Khashram
Steven Dubenec
Gerard S. Goh
Richard A. Settlage
Publication date
30-11-2022
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 1/2023
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-022-03300-1

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