title: Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy.
abstract: OBJECTIVE
  To retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).
  
  
  METHODS
  From October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10-86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up.
  
  
  RESULTS
  To produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess.
  
  
  CONCLUSIONS
  The POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: E
authors.initials: E
authors.lastname: Jambon
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: F
authors.initials: F
authors.lastname: Petitpierre
authors.affiliation: Department of Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Brizzi
authors.affiliation: Department of Surgery, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Dubuisson
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Le Bras
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
authors.forename: N
authors.initials: N
authors.lastname: Grenier
authors.affiliation: Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France. cornelisfrancois@gmail.com.
authors.forename: F
authors.identifier: http://orcid.org/0000-0002-1058-0884
authors.initials: F
authors.lastname: Cornelis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D055815:Young Adult
keywords: Efficacy; Embolization; Interventional radiology; Penumbra occlusion system; Tolerance