Comparison of Clinical and Cost-Effectiveness Between Amplatzer Vascular Plug and Coil Embolization for Prophylactic Internal Iliac Artery Embolization During EVAR
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Objective: This study is a retrospective, single-center study comparing the effectiveness of Amplatzer vascular plug (AVP) with coil embolization in prophylactic internal iliac artery embolization during endovascular aortic aneurysm repair (EVAR). Materials and Methods: We reviewed 146 embolization procedures performed during EVAR from 2009 to 2024. We compared technical success, adverse events (including type II endoleak and buttock claudication), procedure time, and embolization-related costs between the coil embolization group and the AVP embolization group. We also performed multivariate analyses on factors influencing gluteal claudication, procedure time, and procedure costs. Results: Technical success was achieved in all procedures. No significant differences were observed between groups in type II endoleaks and intraoperative vascular injuries. Compared to the coil embolization group, the AVP group had a lower incidence of buttock claudication at 6 months (10% vs. 30%), shorter procedure time, and lower embolization-related costs. Multivariate analysis identified embolic material as an independent factor associated with buttock claudication, procedure time, and procedure cost. Conclusion: Prophylactic internal iliac artery embolization using AVP during EVAR is safe and effective, potentially reducing buttock claudication and lowering procedure time and cost compared to coil embolization while maintaining comparable clinical outcomes.
