E-180 Micro vascular plug (MVP) for craniocervical arterial sacrifice: a retrospective case series
Bibliographic record
Abstract
Purpose Craniocervical arterial sacrifice requires reliable, controlled, and stable device deployment and positioning to achieve durable occlusion while minimizing embolic risk. This retrospective case series evaluates the safety and effectiveness of the Micro Vascular Plug (MVP, Medtronic, Minneapolis, MN)) for craniocervical arterial sacrifice for various head and neck vascular pathologies. Methods and Materials After IRB approval, we retrospectively reviewed medical records of 26 patients between February 2017 to March 2023 at our institution who underwent off-label arterial sacrifice using the MVP as the first device deployed. Demographics, clinical data, procedural details, and outcomes were analyzed. Technical success was defined as successful MVP deployment. Results Arterial sacrifice was performed in 26 arteries with 34 MVP devices (3 mm (n=9), 5 mm (n=21), 7 mm (n=4)) which were deployed using an 0.025’ lumen microcatheter for devices ≤ 5 mm. The technical success rate was 96.2%, successful arterial occlusion was 100%, and the procedure-related complication rate was 3.8%. One patient suffered a post-procedural infarct. 38.4% (10/26) of procedures were performed for adjunctive pre-operative cervical spine tumor resection, and 34.6% (9/26) for intracranial aneurysm or dissection treatment. 18 vertebral and 5 internal carotid arteries were occluded. In addition to the MVP, additional coils were placed into the parent artery for complete occlusion, with a median of 5 (range 0–12, IQR 3–7) coils required. Conclusion Craniocervical arterial sacrifice using the MVP as a distal occluder could be accomplished with precise positioning and reliable deployment, with a high technical success rate and low complication rate. This is the largest case series of its use for intra- and extracranial arterial sacrifice. Further study is warranted. Disclosures C. Kim: None. M. Marangoni: None. F. Settecase: 1; C; Microvention, Stryker. 2; C; Stryker, Route 92 Medical. 3; C; Stryker. 4; C; Route 92 Medical. 6; C; Medtronic, Route 92 Medical. A. Rohr: None. W. Guest: None. S. Mangat: None. G. Redekop: None. C. Haw: None. M. Heran: None.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".