Transcatheter Closure of Ventricular Pseudoaneurysms Using 3D-Shaped Platinum-Based Bare-Metal Coils

Abstract

Ventricular pseudoaneurysms (PSAs) are contained ruptures of the ventricular wall with a high risk of rupture. Though traditionally managed with surgery, percutaneous intervention is an established option for high-risk patients. This case series is the first to evaluate the independent and combined use of large 3-dimensionally (3D) shaped platinum-based bare-metal coils for percutaneous closure of ventricular PSAs. We report on 3 patients presenting with ventricular PSAs in various locations, treated successfully with Penumbra coils alone or in combination with commonly used nitinol closure devices. While closure with a single occluder device may not always achieve complete neck sealing and isolation of the PSA, the combination with bare-metal coils has proven to be an effective and safe strategy in this context. Although these results are promising, the use of 3D-shaped platinum-based bare-metal coils remains off label for high-risk patients, highlighting the need for further research to establish standardized treatment protocols and assess long-term outcomes.

Keywords

• platinum coils
• pseudoaneurysm embolization
• transcatheter closure
• ventricle pseudoaneurysm