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Mijangos-Vázquez R, Hernández-Reyes R. Closure of perimembranous ventricular septal defects using the Amplatzer vascular plug II: experience of a Mexican centre. Cardiol Young 2025; 35:683-687. [PMID: 39989213 DOI: 10.1017/s1047951125000381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2025]
Abstract
OBJECTIVES To demonstrate safety and efficacy of using the AmplatzerTM vascular plug II device for perimembranous ventricular septal defect closure with retrograde approach and show the follow-up in all patients. BACKGROUND At present, there is no FDA-approved device for transcatheter closure of perimembranous ventricular septal defects. Small studies and case reports have shown the use of various catheter-based devices in an off-label management; however, there are no large studies to show their efficacy. The second generation of AmplatzerTM vascular plug seems to offer a safe and attractive alternative for this procedure. Besides, a retrograde approach might decrease procedure time and radiation exposure time. METHODS AND RESULTS Patients with congenital perimembranous ventricular septal defects who underwent transcatheter closure using Amplatzer vascular plug II devices were included. Primary end point was to determine efficacy and safety of this generation of devices and the incidence of complications at follow-up (complete heart block and aortic/tricuspid/mitral regurgitation). Forty-five patients underwent perimembranous ventricular septal defect closure at a median age of 6 years (9 months-17 years). During the catheterization, there were only minor complications and at follow-up of 48 ± 25.7 months (up to 96 months). Closure rate was high of 93.3% and freedom from atrioventricular block was 100%. CONCLUSIONS The second generation of the AmplatzerTM vascular plug II seems to offer a safe and attractive alternative for percutaneous closure of the perimembranous ventricular septal defects.
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Affiliation(s)
- Roberto Mijangos-Vázquez
- Pediatric Interventional Cardiology Department, Pediatric Specialties Hospital, Tuxtla GutiérrezChiapas, México
| | - Rogelio Hernández-Reyes
- Pediatric Interventional Cardiology Department, Pediatric Specialties Hospital, Tuxtla GutiérrezChiapas, México
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Loffroy R, Chevallier O, Mazit A, Malakhia A, Midulla M. Amplatzer ™ Vascular Plugs for Embolisation: A 10-Year Single-Centre Retrospective Study. J Clin Med 2023; 12:6790. [PMID: 37959254 PMCID: PMC10647837 DOI: 10.3390/jcm12216790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
Our objective was to investigate the indications, effectiveness, and safety of Amplatzer™ Vascular Plugs (AVPs) in clinical practice. To retrospectively identify patients managed with AVPs at the Dijon University Hospital between January 2011 and April 2021, we searched materials vigilance registries and procedure reports. The 110 identified patients underwent 111 procedures with delivery of 202 AVPs into 118 vessels; 84% of the procedures were performed by radiologists with over 10 years' experience and 67% were scheduled. Varicocele, haemostasis, pelvic varicose veins, and arterio-venous dialysis fistulas accounted for 69% of procedures. The technical and clinical success rates were 99% and 97%, respectively. The single major complication was AVP migration in a high-flow internal iliac vein, with no residual abnormalities after successful device retrieval. Several AVPs and/or concomitant injection of coils or liquid agents were used in 80% of cases. The use of AVPs alone occurred chiefly for splenic artery embolisation in trauma patients and for collateral vein occlusion in dysfunctional arterio-venous dialysis fistulas. No cases of recanalisation occurred during the 19 ± 29 month follow-ups. Based on their good safety and effectiveness profile, AVPs deserve to be part of the therapeutic armamentarium of every interventional radiologist.
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Affiliation(s)
- Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (A.M.); (A.M.); (M.M.)
- ICMUB Laboratory, UMR CNRS 6302, 9 Avenue Alain Savary, 21000 Dijon, France
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (A.M.); (A.M.); (M.M.)
- ICMUB Laboratory, UMR CNRS 6302, 9 Avenue Alain Savary, 21000 Dijon, France
| | - Amin Mazit
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (A.M.); (A.M.); (M.M.)
| | - Alexandre Malakhia
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (A.M.); (A.M.); (M.M.)
| | - Marco Midulla
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, BP 77908, 21079 Dijon, France; (O.C.); (A.M.); (A.M.); (M.M.)
- ICMUB Laboratory, UMR CNRS 6302, 9 Avenue Alain Savary, 21000 Dijon, France
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Fujioka S, Kitamura T, Mishima T, Mori H, Fukuzumi M, Shikata F, Miyaji K. Coil-in-Plug Method for Left Subclavian Artery Embolization in Thoracic Endovascular Aortic Repair with Arch Vessel Debranching. Ann Vasc Dis 2023; 16:189-194. [PMID: 37779651 PMCID: PMC10539117 DOI: 10.3400/avd.oa.23-00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/04/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives: Since 2018, we have routinely placed an Amplatzer vascular plug (AVP) in the proximal left subclavian artery (LSCA) to prevent embolic events during thoracic endovascular aortic repair with arch vessel debranching (d-TEVAR). Type II endoleaks of LSCA origin were observed in two patients (20%), and the coil-in-plug (CIP) method, i.e., microcatheter insertion through the plug and addition of coil embolization, which has been used since August 2019, was performed. This study aims to evaluate the effectiveness of the CIP method for LSCA embolization. Methods: A total of 26 patients who underwent d-TEVAR for an aortic arch aneurysm between 2018 and 2022 were retrospectively reviewed. Ten patients who underwent d-TEVAR with a simple AVP placement (the control group) and 16 patients who underwent d-TEVAR with the CIP method (the CIP group) were compared. Results: Two patients had type II endoleaks in the control group, whereas none had them in the CIP group. LSCA length was significantly shorter in patients with endoleaks than in those without endoleaks (24.5 vs. 50.3 mm; p<0.01). No perioperative deaths or cerebral infarctions occurred in either group. Conclusions: AVP placement in the LSCA during d-TEVAR effectively prevented perioperative cerebral infarction. d-TEVAR with CIP was especially useful in patients with a short LSCA.
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Affiliation(s)
- Shunichiro Fujioka
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Tadashi Kitamura
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Toshiaki Mishima
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Hisaya Mori
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Masaomi Fukuzumi
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Fumiaki Shikata
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
| | - Kagami Miyaji
- Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
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4
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Sheikh AB, Fudim M, Garg I, Minhas AMK, Sobotka AA, Patel MR, Eng MH, Sobotka PA. The Clinical Problem of Pelvic Venous Disorders. Interv Cardiol Clin 2022; 11:307-324. [PMID: 35710285 DOI: 10.1016/j.iccl.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Pelvic venous disorders are inter-related pathologic conditions caused by reflux and obstruction in the pelvic veins. It can present a spectrum of clinical features based on the route of transmission of venous hypertension to either distal or caudal venous reservoirs. Imaging can help to visualize pelvic vascular and visceral structures to rule out other gynecologic, gastrointestinal, and urologic diseases. Endovascular treatment, owing to its low invasive nature and high success rate, has become the mainstay in the management of pelvic venous disorders. This article reviews the pathophysiology, clinical presentations, and diagnostic and therapeutic approaches to pelvic venous disorders.
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Affiliation(s)
- Abu Baker Sheikh
- Department of Internal Medicine, University of New Mexico Health Sciences Center, 1021 Medical Arts Avenue NE, Albuquerque, NM 87102, USA
| | - Marat Fudim
- Division of Cardiology, Duke University Medical Center, 200 Trent Drive, Durham, NC 27710, USA; Duke Clinical Research Institute, 300 West Morgan Street, Durham, NC 27701, USA.
| | - Ishan Garg
- Department of Internal Medicine, University of New Mexico Health Sciences Center, 1021 Medical Arts Avenue NE, Albuquerque, NM 87102, USA
| | - Abdul Mannan Khan Minhas
- Department of Internal Medicine, Forrest General Hospital, 6051 US 49, Hattiesburg, MS 39401, USA
| | | | - Manesh R Patel
- Division of Cardiology, Duke University Medical Center, 200 Trent Drive, Durham, NC 27710, USA; Duke Clinical Research Institute, 300 West Morgan Street, Durham, NC 27701, USA
| | - Marvin H Eng
- Division of Cardiology, University of Arizona, Banner University Medical Center, 1111 E McDowell Rd, Phoenix, AZ 85006, USA
| | - Paul A Sobotka
- The Ohio State University, 281 West Lane Avenue, Columbus, OH 43210, USA.
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Dzhagraev KR, Muslimov RS, Klimov AB, Ryabukhin VE, Kim TE, Selina IE, Kiryushchenkov VP, Moskalenko VA, Kokov LS. Endovascular Occlusion of Giant Posttraumatic Pseudo-Aneurysm of Superior Mesenteric Artery Connected to Mesenteric Arteriovenous Fistula. Sovrem Tekhnologii Med 2021; 12:55-61. [PMID: 34795993 PMCID: PMC8596274 DOI: 10.17691/stm2020.12.4.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Indexed: 11/27/2022] Open
Abstract
The aim of the study was to show the capabilities of endovascular occlusion of giant posttraumatic pseudo-aneurysm of superior mesenteric artery (SMA) connected to a mesenteric arteriovenous fistula (AVF) under the conditions of portal hypertension and life-threatening esophageal variceal bleeding.
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Affiliation(s)
- K R Dzhagraev
- Leading Researcher, Department of Emergency Surgery, Endoscopy and Resuscitation; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia; Associate Professor, Department of Emergency and General Surgery; Russian Medical Academy of Continuous Professional Education, 2/1, Bldg 1, Barrikadnaya St., Moscow, 125993, Russia
| | - R Sh Muslimov
- Leading Researcher, Department of Radiation Diagnostics; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - A B Klimov
- Physician, Department of X-ray Surgery Diagnosis and Therapy; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - V E Ryabukhin
- Physician, Department of X-ray Surgery Diagnosis and Therapy; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - T E Kim
- Physician, 2 Surgery Department; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - I E Selina
- Leading Researcher, Department of Radiation Diagnostics; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - V P Kiryushchenkov
- Physician, Department of X-ray Surgery Diagnosis and Therapy; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - V A Moskalenko
- Physician, Department of X-ray Surgery Diagnosis and Therapy; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia
| | - L S Kokov
- Professor, Academician of the Russian Academy of Sciences, Head of the Department of Radiation Diagnostics; N.V. Sklifosovsky Research Institute of Emergency Care, 3 Bolshaya Sukharevskaya Square, Moscow, 129090, Russia; Head of the Radiodiagnosis Department, Institute of Professional Education I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2 Trubetskaya St., Moscow, 119991, Russia
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Kotoku A, Ogawa Y, Chiba K, Maruhashi T, Mimura H, Miyairi T, Nishimaki H. Clinical Utility of Coil in Plug Method (CIP) for Internal Iliac Artery Embolization during Endovascular Aortic Aneurysm Repair. Ann Vasc Dis 2020; 13:269-272. [PMID: 33384729 PMCID: PMC7751075 DOI: 10.3400/avd.oa.20-00034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: To evaluate the clinical utility of the coil in plug (CIP) method in internal iliac artery (IIA) embolization during endovascular aortic aneurysm repair (EVAR) compared to conventional coil embolization (CCE). Material and Methods: From July to December 2018, 10 patients who underwent IIA embolization during EVAR were divided into CIP (n=5) and CCE (n=5) groups. In the CIP technique, the AVP-1 with a size more than 30%–50% of that of the embolized IIA diameter was used. The AVP-1 was deployed in the IIA. Before detachment of the AVP-1, a 2.2-F micro catheter was inserted through the 6-F delivery guiding sheath, and entered the plug. The AVP-1 was then packed with hydrogel micro coils. We compared number of coils used, embolization length, embolization time, volume embolization ratio, and embolic material cost between the groups. Results: The CIP method achieved shorter embolization length with fewer coils used compared to CCE. The CIP method decreased the cost of total embolic materials. Conclusion: The CIP method can achieve shorter embolization length with fewer coils used compared to CCE.
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Affiliation(s)
- Akiyuki Kotoku
- Department of Radiology, St. Marianna University, School of Medicine
| | - Yukihisa Ogawa
- Department of Radiology, St. Marianna University, School of Medicine
| | - Kiyoshi Chiba
- Department of Cardiovascular Surgery, St. Marianna University, School of Medicine
| | - Takaaki Maruhashi
- Department of Cardiovascular Surgery, St. Marianna University, School of Medicine.,Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine
| | - Hidefumi Mimura
- Department of Radiology, St. Marianna University, School of Medicine
| | - Takeshi Miyairi
- Department of Cardiovascular Surgery, St. Marianna University, School of Medicine
| | - Hiroshi Nishimaki
- Department of Cardiovascular Surgery, St. Marianna University, School of Medicine
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Bookwalter CA, VanBuren WM, Neisen MJ, Bjarnason H. Imaging Appearance and Nonsurgical Management of Pelvic Venous Congestion Syndrome. Radiographics 2020; 39:596-608. [PMID: 30844351 DOI: 10.1148/rg.2019180159] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Pelvic venous congestion syndrome (PVCS) is a challenging and complex cause of chronic pelvic pain in female patients. PVCS due to incompetent vein valves is the combination of gonadal vein reflux and pelvic venous engorgement in patients with chronic pelvic pain without other causes. However, pelvic venous engorgement and gonadal vein reflux can be seen in patients without pelvic pain, which makes obtaining a detailed history and physical examination important for workup and diagnosis. The underlying cause of PVCS may be incompetent gonadal vein valves or structural causes such as left renal vein compression with an incompetent gonadal vein valve (nutcracker syndrome) or iliac vein compression (May-Thurner configuration) with reflux into the ipsilateral internal iliac vein. Venography is considered the criterion standard for imaging diagnosis; however, more recently, US and MRI have been shown to provide adequate accuracy for diagnosis. Noninvasive imaging studies aid in the diagnosis of PVCS and also aid in pretreatment planning. When PVCS is caused by incompetent gonadal vein valves, treatment typically is performed by means of embolization via a minimally invasive catheter with excellent technical and clinical success rates. When PVCS is caused by venous obstruction, the obstruction must be treated first before gonadal vein embolization and sclerotherapy are considered. ©RSNA, 2019 Online supplemental material is available for this article.
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Affiliation(s)
- Candice A Bookwalter
- From the Department of Radiology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN 55905
| | - Wendaline M VanBuren
- From the Department of Radiology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN 55905
| | - Melissa J Neisen
- From the Department of Radiology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN 55905
| | - Haraldur Bjarnason
- From the Department of Radiology, Mayo Clinic Rochester, 200 First St SW, Rochester, MN 55905
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8
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Li ZP, Wang SS, Wang GC, Huang GJ, Cao JQ, Zhang CQ. Transjugular intrahepatic portosystemic shunt for the prevention of recurrent esophageal variceal bleeding in patients with cavernous transformation of portal vein. Hepatobiliary Pancreat Dis Int 2018; 17:517-523. [PMID: 30262421 DOI: 10.1016/j.hbpd.2018.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 08/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Treatment options for patients with cavernous transformation of portal vein (CTPV) are limited. This study aimed to evaluate the feasibility, efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) to prevent recurrent esophageal variceal bleeding in patients with CTPV. METHODS We retrospectively analyzed 67 consecutive patients undergone TIPS from January 2011 to December 2016. All patients were diagnosed with CTPV. The indication for TIPS was a previous episode of variceal bleeding. The data on recurrent bleeding, stent patency, hepatic encephalopathy and survival were retrieved and analyzed. RESULTS TIPS procedure was successfully performed in 56 out of 67 (83.6%) patients with CTPV. TIPS was performed via a transjugular approach alone (n = 15), a combined transjugular/transhepatic approach (n = 33) and a combined transjugular/transsplenic approach (n = 8). Mean portosystemic pressure gradient (PSG) decreased from 28.09 ± 7.28 mmHg to 17.53 ± 6.12 mmHg after TIPS (P < 0.01). The probability of the remaining free recurrent variceal bleeding was 87.0%. The probability of TIPS patency reached 81.5%. Hepatic encephalopathy occurrence was 27.8%, and survival rate was 88.9% until the end of follow-up. Four out of 11 patients who failed TIPS died, and 4 had recurrent bleeding. CONCLUSIONS TIPS should be considered a safe and feasible alternative therapy to prevent recurrent esophageal variceal bleeding in patients with CTPV, and to achieve clinical improvement.
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Affiliation(s)
- Zhao-Peng Li
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China; Department of Interventional Radiology, Jining No.1 People(')s Hospital, Jining 272011, China
| | - Sui-Sui Wang
- Department of Pediatrics, The Affiliated Hospital of Jining Medical College, Jining 272000, China
| | - Guang-Chuan Wang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
| | - Guang-Jun Huang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
| | - Jing-Qin Cao
- Department of Interventional Radiology, Jining No.1 People(')s Hospital, Jining 272011, China
| | - Chun-Qing Zhang
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China.
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Bui J, Gaba R, Knuttinen M, West D, Owens C. Amplatzer Vascular Plug for Arteriovenous Hemodialysis Access Occlusion: Initial Experience. J Vasc Access 2018; 10:5-10. [DOI: 10.1177/112972980901000102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose The Amplatzer Vascular Plug (AVP; AGA Medical, Golden Valley, MN) is a recently developed self-expanding metallic device indicated for peripheral vascular embolizations. Herein, we describe use of this device in the treatment of vascular complications related to arteriovenous hemodialysis fistulas and grafts. Materials and methods This HIPAA compliant retrospective study was approved by the institutional review board with informed consent waived. Six patients with problematic arteriovenous access underwent access occlusion using the AVP. Procedure indications included vascular steal syndrome in five patients, and enlarging vascular aneurysms in one patient. Contraindications for surgical correction were determined by the referring surgeon. AVP embolizations were performed using devices oversized by 50% introduced through vascular sheaths positioned within vein segments just beyond the arteriovenous anastomoses. Noninvasive evaluation of the involved extremity was performed pre- and post-embolization in addition to clinical follow-up examinations. Measured outcomes included success of angiographic occlusion, improvement in distal arterial flow, AVP number, AVP diameter, time to access occlusion, and clinical symptomatic improvement. Results Technical success was 100%, with complete arteriovenous access occlusion accomplished in all cases, with an average of 1.5 AVPs used per patient. Mean time to access occlusion was 19.3 minutes. Angiographic improvement in distal arterial flow was immediately evident and resolution of clinical symptoms occurred in all patients, with mean long-term follow-up of 16 months. No procedure-related complications were encountered. Conclusion The Amplatzer Vascular Plug provides a minimally invasive and efficacious method for embolization of problematic arteriovenous hemodialysis access.
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Affiliation(s)
- J.T. Bui
- Department of Radiology, University of Illinois Medical Center at Chicago, Chicago, IL - USA
| | - R.C. Gaba
- Department of Radiology, University of Illinois Medical Center at Chicago, Chicago, IL - USA
| | - M.G. Knuttinen
- Department of Radiology, University of Illinois Medical Center at Chicago, Chicago, IL - USA
| | - D.L. West
- Department of Radiology, University of Illinois Medical Center at Chicago, Chicago, IL - USA
| | - C.A. Owens
- Department of Radiology, University of Illinois Medical Center at Chicago, Chicago, IL - USA
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10
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Lee W, Shin YS, Kim KH, Kim YB, Hong CK, Chung J. Preliminary Experience with Vascular Plugs for Parent Artery Occlusion of the Carotid or Vertebral Arteries. J Cerebrovasc Endovasc Neurosurg 2016; 18:208-214. [PMID: 27847763 PMCID: PMC5104844 DOI: 10.7461/jcen.2016.18.3.208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 08/30/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this study was to report the authors' preliminary experience using the Amplatzer Vascular Plug (AVP) (St. Jude Medical, Plymouth, MN, USA) for parent artery occlusion of the internal carotid artery (ICA) or vertebral artery (VA). MATERIALS AND METHODS Between September 2008 and December 2015, we performed 52 therapeutic parent artery occlusions (PAOs) by an endovascular technique. Among them, 10 patients underwent PAO of the carotid or vertebral arteries using AVPs. Clinical and radiographic data of these patients were retrospectively reviewed. RESULTS The devices were used for VA dissection that presented with subarachnoid hemorrhage (SAH) in five patients, traumatic arteriovenous fistula (AVF) in two patients, spontaneous AVF in one patient, recurrence of carotid-cavernous fistula (CCF) in one patient, and symptomatic unruptured giant ICA aneurysm in one patient. The devices were used in conjunction with detachable and/or pushable coils and in the extracranial segments of the ICA or VA. Complete occlusion of the parent artery was achieved in all patients. There was one intra-procedural rupture of the VA dissection during coiling prior to using the device. CONCLUSION Results from the current series suggest that the AVP might be used for therapeutic PAO in the extracranial segments of the ICA or VA.
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Affiliation(s)
- Woosung Lee
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Sam Shin
- Department of Neurosurgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kyung Hyun Kim
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Chang-Ki Hong
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea
| | - Joonho Chung
- Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Korea.; Department of Neurological Surgery, Rush University Medical Center, Chicago, IL, USA
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11
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Tresley J, Bhatia S, Kably I, Poozhikunnath Mohan P, Salsamendi J, Narayanan G. Amplatzer vascular plug as an embolic agent in different vascular pathologies: A pictorial essay. Indian J Radiol Imaging 2016; 26:254-61. [PMID: 27413276 PMCID: PMC4931788 DOI: 10.4103/0971-3026.184422] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Amplatzer Vascular Plug (AVP) is a cylindrical plug made of self-expanding nitinol wire mesh with precise delivery control, which can be used for a variety of vascular pathologies. An AVP is an ideal vascular occlusion device particularly in high-flow vessels, where there is high risk of migration and systemic embolization with traditional occlusion devices. We performed 28 embolizations using the AVP from 2009 to 2014 and achieved complete occlusion without complications.
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Affiliation(s)
- Jonathan Tresley
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
| | - Shivank Bhatia
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
| | - Issam Kably
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
| | - Prasoon Poozhikunnath Mohan
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
| | - Jason Salsamendi
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
| | - Govindarajan Narayanan
- Department of Diagnostic and Vascular/Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, USA
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Mantilla JM, Olaya JL, Enriquez MF, Vanegas E, Cely-Andrade JL. Tratamiento quirúrgico en un caso de migración de Amplatzer® en un menor con persistencia del conducto arterioso. CIRUGIA CARDIOVASCULAR 2016. [DOI: 10.1016/j.circv.2015.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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13
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Pereira-da-Silva T, Martins JD, de Sousa L, Fiarresga A, Trigo Pereira C, Cruz Ferreira R, Ferreira Pinto F. Percutaneous occlusion of vascular malformations in pediatric and adult patients: 20-Year Experience of a Single Center. Catheter Cardiovasc Interv 2015; 87:E62-8. [DOI: 10.1002/ccd.26220] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 08/02/2015] [Accepted: 08/09/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Tiago Pereira-da-Silva
- Department of Cardiology; Hospital De Santa Marta, Centro Hospitalar De Lisboa Central, Lisbon, Portugal
| | - José Diogo Martins
- Department of Pediatric Cardiology, Hospital De Santa Marta; Centro Hospitalar De Lisboa Central; Lisbon Portugal
| | - Lídia de Sousa
- Department of Cardiology; Hospital De Santa Marta, Centro Hospitalar De Lisboa Central, Lisbon, Portugal
| | - António Fiarresga
- Department of Cardiology; Hospital De Santa Marta, Centro Hospitalar De Lisboa Central, Lisbon, Portugal
| | - Conceição Trigo Pereira
- Department of Pediatric Cardiology, Hospital De Santa Marta; Centro Hospitalar De Lisboa Central; Lisbon Portugal
| | - Rui Cruz Ferreira
- Department of Cardiology; Hospital De Santa Marta, Centro Hospitalar De Lisboa Central, Lisbon, Portugal
| | - Fátima Ferreira Pinto
- Department of Pediatric Cardiology, Hospital De Santa Marta; Centro Hospitalar De Lisboa Central; Lisbon Portugal
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Ramakrishnan S. Vascular plugs - A key companion to Interventionists - 'Just Plug it'. Indian Heart J 2015; 67:399-405. [PMID: 26304581 DOI: 10.1016/j.ihj.2015.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 07/02/2015] [Indexed: 11/18/2022] Open
Abstract
Vascular plugs are ideally suited to close extra-cardiac, high flowing vascular communications. The family of vascular plugs has expanded. Vascular plugs in general have a lower profile and the newer variants can be delivered even through a diagnostic catheter. These features make them versatile and easy to use. The Amplatzer vascular plugs are also used for closing intracardiac defects including coronary arterio-venous fistula and paravalvular leakage in an off-label fashion. In this review, the features of currently available vascular plugs are reviewed along with tips and tricks of using them in the cardiac catheterization laboratory.
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A case-based approach to common embolization agents used in vascular interventional radiology. AJR Am J Roentgenol 2014; 203:699-708. [PMID: 25247933 DOI: 10.2214/ajr.14.12480] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The objective of this article is to familiarize the reader with the most commonly used embolic agents in interventional radiology and discuss an approach for selecting among the different embolic agents. This article reviews their properties and uses a case-based approach to explain how to select one. CONCLUSION A wide variety of embolic agents are available. Familiarity with the available embolic agents and selection of the most appropriate embolic agent is critical in interventional radiology to achieve optimum therapeutic response and avoid undesired, potentially disastrous complications such as nontarget embolization.
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Al-Juboori O, Alani A, Al-ani A, Kudaravalli P, Budoff MJ. Amplatzer vascular plug for patent ductus arteriosus migrated to pulmonary artery six months after closure in a 59 year old female. Int J Cardiol 2014; 176:1080-1. [PMID: 25127975 DOI: 10.1016/j.ijcard.2014.07.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 07/26/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Omar Al-Juboori
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | - Anas Alani
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | - Aseel Al-ani
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA
| | | | - Matthew J Budoff
- Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA, USA.
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Barwad P, Ramakrishnan S, Kothari SS, Saxena A, Gupta SK, Juneja R, Gulati GS, Jagia P, Sharma S. Amplatzer vascular plugs in congenital cardiovascular malformations. Ann Pediatr Cardiol 2014; 6:132-40. [PMID: 24688229 PMCID: PMC3957441 DOI: 10.4103/0974-2069.115255] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Amplatzer vascular plugs (AVPs) are devices ideally suited to close medium-to-large vascular communications. There is limited published literature regarding the utility of AVPs in congenital cardiovascular malformations (CCVMs). AIMS To describe the use of AVPs in different CCVMs and to evaluate their safety and efficacy. MATERIALS AND METHODS All patients who required an AVP for the closure of CCVM were included in this retrospective review of our catheterization laboratory data. The efficacy and safety of AVPs are reported. RESULTS A total of 39 AVPs were implanted in 31 patients. Thirteen (33%) were AVP type I and 23 (59%) were AVP type II. AVP type III were implanted in two patients and type IV in one patient. The major indications for their use included closure of pulmonary arteriovenous malformation (AVM) (n = 7), aortopulmonary collaterals (n = 7), closure of a patent Blalock-Taussig shunt (n = 5), systemic AVM (n = 5), coronary AVM (n = 4), patent ductus arteriosus (PDA) (n = 3), pulmonary artery aneurysms (n = 3), and venovenous collaterals (n = 2). Deployment of the AVP was done predominantly via the 5 - 7F Judkin's right coronary guide catheter. Overall 92% of the AVPs could be successfully deployed and resulted in occlusion of the target vessel in all cases, within 10 minutes. No procedure-related or access site complication occurred. CONCLUSIONS AVPs are versatile, easy to use, and effective devices to occlude the vascular communications in a variety of settings. AVP II is especially useful in the closure of tubular structures with a high flow.
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Affiliation(s)
- Parag Barwad
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Shyam S Kothari
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Saxena
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh K Gupta
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajnish Juneja
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Gurpreet Singh Gulati
- Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Priya Jagia
- Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Sanjiv Sharma
- Department of Cardiac Radiology, All India Institute of Medical Sciences, New Delhi, India
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18
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Comparison of CT and MRI artefacts from coils and vascular plugs used for portal vein embolization. Eur J Radiol 2014; 83:692-5. [DOI: 10.1016/j.ejrad.2014.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Revised: 11/26/2013] [Accepted: 01/06/2014] [Indexed: 12/28/2022]
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Large pulmonary arteriovenous malformations: long-term results of embolization with AMPLATZER vascular plugs. J Vasc Interv Radiol 2014; 25:1327-32. [PMID: 24656179 DOI: 10.1016/j.jvir.2014.01.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 01/26/2014] [Accepted: 01/27/2014] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To analyze the long-term results of endovascular treatment of large pulmonary arteriovenous malformations (PAVMs) using the AMPLATZER vascular plug (AVP; AGA Medical Corp, Golden Valley, Minnesota). MATERIALS AND METHODS Between May 2007 and April 2011, 18 patients with 24 large PAVMs, defined as PAVMs that had a feeding artery with a diameter of ≥ 8 mm, were treated with AVP I or AVP II. A single AVP device was used for each PAVM. Aneurysmal sac diameters, sac perfusion, sac shrinkage, and complete resolution before and after the intervention were analyzed. Complete histories, laboratory values, physical examinations, and multidetector computed tomography images were reviewed. The mean occlusion time for AVP I and AVP II and the mean arterial oxygen saturation (SaO2) before and after the intervention were compared. RESULTS The mean diameter of the feeding artery was 11.46 mm ± 2.18 (range, 8-13.3 mm). The mean occlusion time was 7.34 minutes ± 1.23 for AVP I and 6.25 minutes ± 1.12 for AVP II (P = .11). The mean SaO2 before and after the intervention was 63.71% ± 8.10% (range, 51%-76%) and 96.28% ± 0.49% (range, 96%-97%), respectively (P = .045). No major periprocedural complications were observed. The mean follow-up duration was 36.33 months ± 10.63 (range, 28-56 mo). During the follow-up period, there were no persistent sac perfusions, migration of the AVPs, major complications, or recanalizations. CONCLUSIONS Treatment of large PAVMs with AVPs is an effective method for obtaining excellent long-term results. Embolization of large feeding arteries can be accomplished with AVPs without major complications.
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Nardone R, Höller Y, Storti M, Lochner P, Tezzon F, Golaszewski S, Brigo F, Trinka E. Spinal cord involvement in patients with cirrhosis. World J Gastroenterol 2014; 20:2578-85. [PMID: 24627593 PMCID: PMC3949266 DOI: 10.3748/wjg.v20.i10.2578] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2013] [Revised: 01/03/2014] [Accepted: 01/20/2014] [Indexed: 02/06/2023] Open
Abstract
A severe spinal cord involvement may rarely occur in patients with cirrhosis and other chronic liver diseases; this complication is usually associated with overt liver failure and surgical or spontaneous porto-systemic shunt. Hepatic myelopathy (HM) is characterized by progressive weakness and spasticity of the lower extremities, while sensory and sphincter disturbances have rarely been described and are usually less important. The diagnosis is assigned in the appropriate clinical setting on clinical grounds after the exclusion of other clinical entities leading to spastic paraparesis. Magnetic resonance imaging is often unremarkable; however, also intracerebral corticospinal tract abnormalities have been reported recently. The study of motor evoked potentials may disclose central conduction abnormalities even before HM is clinically manifest. HM responds poorly to blood ammonia-lowering and other conservative medical therapy. Liver transplantation represents a potentially definitive treatment for HM in patients with decompensated cirrhosis of Child-Pugh B and C grades. Other surgical treatment options in HM include surgical ligation, shunt reduction, or occlusion by interventional procedures.
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21
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Leyon JJ, Littlehales T, Rangarajan B, Hoey ET, Ganeshan A. Endovascular Embolization: Review of Currently Available Embolization Agents. Curr Probl Diagn Radiol 2014; 43:35-53. [DOI: 10.1067/j.cpradiol.2013.10.003] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Rohit MK, Sinha AK, Kamana NK. Early experience on peripheral vascular application of the vascular plugs. Indian Heart J 2013; 65:536-45. [PMID: 24206877 DOI: 10.1016/j.ihj.2013.08.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 07/23/2013] [Accepted: 08/09/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Transcatheter closure of various congenital and acquired vascular malformations with Amplatzer Vascular plugs I and II has been established. Here we present our experience with device closure. MATERIALS AND METHODS Between October 2006 and August 2012, nine (three males and six females) patients aged between 11 months and 62 years (mean age 19 years) underwent percutaneous device closure with AVP I and II vascular plugs for congenital and acquired arteriovenous malformation and cardiac diverticulum are presented here. RESULTS One case of coronary cameral fistula, four cases of pulmonary arteriovenous fistula, one case of large major aortopulmonary collaterals (in tetralogy of Fallot closed before intracardiac repair), one case of congenital cardiac diverticulum, one case of fistula between external carotid artery and internal jugular vein and one case of iatrogenic carotid jugular fistula were successfully closed with AVP I and II plugs. Overall in nine cases, 16 AVP I and II plugs were deployed to occlude feeding vessels and one cardiac diverticulum. The technical success rate was 100%. No major complications were observed. CONCLUSION Amplatzer vascular plugs can be used successfully for closure of various congenital and acquired vascular malformations with good result.
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Affiliation(s)
- Manoj Kumar Rohit
- Additional Professor, Department of Cardiology, Advanced Cardiac Center, PGIMER, Chandigarh 160012, India.
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23
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Gelfoam-assisted amplatzer vascular plug technique for rapid occlusion in proximal splenic artery embolization. AJR Am J Roentgenol 2013; 200:677-81. [PMID: 23436862 DOI: 10.2214/ajr.12.8949] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this study was to prospectively investigate the role of rapid Gelfoam-assisted occlusion of the splenic artery with an Amplatzer Vascular Plug (AVP). Ten consecutive proximal splenic artery embolizations were performed with AVP as the primary embolic agent and Gelfoam slurry as an adjunct. These cases were then compared with 10 retrospective cases of splenic artery embolization performed with AVP and augmented with coils or additional AVPs, or both, in patients with similar indications. CONCLUSION Successful proximal splenic artery embolization using a single Amplatzer Vascular Plug and Gelfoam slurry occurred in all cases. No recanalization was identified on imaging follow-up at an average interval of 5.1 months. Gelfoam can be used as an adjunct to AVP in proximal splenic artery embolization. Using adjunctive Gelfoam is a simple, safe, and cost-saving method of improving the occlusion efficiency of the Amplatzer Vascular Plug.
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Feasibility of a dual microcatheter-dual interlocking detachable coil technique in preoperative embolization in preparation for distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2013; 19:431-7. [PMID: 21938409 DOI: 10.1007/s00534-011-0455-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To describe the feasibility of a dual microcatheter-dual interlocking detachable coil (DMDI) technique for preoperative embolization of the common hepatic artery (CHA) in preparation for distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for locally advanced pancreatic body cancer. METHODS From January 2007 to December 2009, 26 patients underwent embolization of the CHA by the DMDI technique. We compared the results with those of 37 patients in whom the CHA was embolized by conventional techniques from August 1998 to February 2007. RESULTS With the DMDI technique, no coil migration or other embolization-related complications occurred. The success rate was 100%. The rate of embolization-related complications was significantly lower in the DMDI embolization group (0%) than in the conventional embolization group (24.3%) (P = 0.008). The frequency of improper positioning of the embolic material necessitating its removal during DP-CAR was significantly lower in the DMDI embolization group (10%) than in the conventional embolization group (37.5%) (P = 0.044). CONCLUSION The DMDI technique allows the development of collateral pathways, reduces the surgeon's burden in ligating the distal CHA, and prevents coil migration. For these reasons, we believe that this technique is feasible for embolization of the CHA in preparation for DP-CAR for locally advanced pancreatic body cancer.
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Percutaneous embolization of idiopathic renal arteriovenous fistula using Amplatzer vascular plug II. Int Urol Nephrol 2012; 45:61-8. [PMID: 23266863 DOI: 10.1007/s11255-012-0358-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 12/08/2012] [Indexed: 12/16/2022]
Abstract
Renal arteriovenous fistula (AVF) presents a rare but important condition that can be acquired, congenital, or idiopathic. Embolization techniques have recently been considered the first-line therapy in the treatment of these lesions, but they carry a possible high risk of distal migration of embolic agents into the venous and pulmonary circulation. This risk is especially important with large, high-flow fistulas. In this report, we present a case in which a 31-year-old man with a symptomatic idiopathic AVF was treated with embolization using the Amplatzer vascular plug II after unsuccessful superselective embolization using coils. This method allowed for complete occlusion of the high-flow fistula with good preservation of arterial supply to the renal parenchyma.
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26
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Wang MQ, Liu FY, Duan F. Management of surgical splenorenal shunt-related hepatic myelopathy with endovascular interventional techniques. World J Gastroenterol 2012; 18:7104-8. [PMID: 23323015 PMCID: PMC3531701 DOI: 10.3748/wjg.v18.i47.7104] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 08/25/2012] [Accepted: 09/19/2012] [Indexed: 02/06/2023] Open
Abstract
We present a case with hepatic myelopathy (HM) due to a surgical splenorenal shunt that was successfully treated by endovascular interventional techniques. A 39-year-old man presented with progressive spastic paraparesis of his lower limbs 14 mo after a splenorenal shunt. A portal venogram identified a widened patent splenorenal shunt. We used an occlusion balloon catheter initially to occlude the shunt. Further monitoring of the patient revealed a decrease in his serum ammonia level and an improvement in leg strength. We then used an Amplatzer vascular plug (AVP) to enable closure of the shunt. During the follow up period of 7 mo, the patient experienced significant clinical improvement and normalization of blood ammonia, without any complications. Occlusion of a surgically created splenorenal shunt with AVP represents an alternative therapy to surgery or coil embolization that can help to relieve shunt-induced HM symptoms.
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The Amplatzer Vascular Plug: A Review of the Device and its Clinical Applications. Cardiovasc Intervent Radiol 2012; 35:725-40. [DOI: 10.1007/s00270-012-0387-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 03/25/2012] [Indexed: 12/16/2022]
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Tam MDBS, Morrow D, Crawford MB. Use of an Amplatzer Vascular Plug II for Aortic Sac Occlusion After Failed Surgical Ligation. Vasc Endovascular Surg 2012; 46:176-8. [DOI: 10.1177/1538574411433297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: To present a case of aortic sac occlusion using an Amplatzer vascular plug II (AVP). Case report: A patient with sigmoid malignancy and an infrarenal aortic aneurysm ultimately required an axillobifemoral graft for acute limb ischemia. The sac was ligated at subsequent laparotomy. Persistent filling of the sac was seen post surgery, and the sac was successfully occluded with placement of an AVP in the neck of the sac in conjunction with coil embolization of lumbar arteries. Sac occlusion was confirmed at follow-up CT. Conclusion: The AVP was successfully used to occlude an aortic sac after failed surgical ligation, another novel indication for this versatile embolic device.
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Affiliation(s)
- Matthew D. B. S. Tam
- Interventional Radiology Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UB, United Kingdom
| | - Darren Morrow
- Department of Vascular Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UB, United Kingdom
| | - Michael B. Crawford
- Interventional Radiology Unit, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UB, United Kingdom
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29
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Hicks TD, Kedora JC, Shutze WP. Treatment of an ilioenteric fistula with an Amplatzer Vascular Plug. J Vasc Surg 2011; 54:1495-7. [DOI: 10.1016/j.jvs.2011.05.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 04/29/2011] [Accepted: 05/02/2011] [Indexed: 11/17/2022]
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30
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Hwang HP, Yang JD, Jeong JH, Han YM, Yu HC, Cho BH. Endovascular Treatment of an Internal Iliac Artery Aneurysm Using Amplatzer Vascular Plug: 2 Case Reports. Vasc Specialist Int 2011. [DOI: 10.5758/kjves.2011.27.3.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Hong Pil Hwang
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Jae Do Yang
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Ji Hyeon Jeong
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Young Min Han
- Department of Radiology, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Hee Chul Yu
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
| | - Baik Hwan Cho
- Department of Surgery, Chonbuk National University School of Medicine, Jeonju, Korea
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Abstract
Therapeutic embolization is a common procedure in interventional radiology. A wide variety of agents are available, and each has its own place and use. Additionally, many new agents have appeared on the market in the past several years. The aim of this review article is to give a brief description of available agents, guide appropriate selection, and familiarize the reader regarding appropriate use and limitations.
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Affiliation(s)
- Sandeep Vaidya
- Department of Radiology, University of Washington, Seattle, Washington
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32
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Turk AS, Turner RD, Chaudry MI. Evaluation of the Nfocus LUNA, a new parent vessel occlusion device: a comparative study in a canine model. Neurosurgery 2011; 69:ons20-6. [PMID: 21368686 DOI: 10.1227/neu.0b013e318214ab9c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Parent artery occlusion is sometimes required to treat cerebrovascular lesions. OBJECTIVE We evaluated the Nfocus LUNA parent vessel occlusion (PVO) device in comparison with the Vascular Plug (AVP) used in the peripheral vasculature for large-vessel occlusion in a canine animal model. METHODS The subclavian arteries were targeted for occlusion in 7 canines. Each animal received 1 LUNA and 1 AVP device sequentially rotated between the left and right subclavian arteries. Angiographic assessment was performed serially after device placement until vessel occlusion was observed and then again immediately before the animal was killed. Three animals were euthanized at 1 month and 4 at 2 months post-implantation, after which the native artery segments containing the implanted device were harvested and preserved for subsequent histological analysis. RESULTS The LUNA PVO device and the AVP were accurately positioned and deployed in all cases. Acute occlusion times for the devices were not statistically different. In no instance was there any evidence of device migration. At 28 and 55 days, the LUNA implants showed nearly complete occlusion with small recanalization channels, whereas the AVP devices were associated with low occlusion levels and large residual vascular channels within the occluder. CONCLUSION The LUNA PVO device and delivery system can be accurately placed to occlude vessels without migration and with a performance that is similar to the AVP. The LUNA PVO device on average provided a higher degree of occlusion durability at both 1 and 2 months.
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Affiliation(s)
- Aquilla S Turk
- Stroke and Cerebrovascular Center, Department of Radiology, Medical University of South Carolina, Charleston, South Carolina 29466, USA.
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33
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Kim SK, Chun HJ, Choi BG, Lee HG, Bae SH, Choi JY. Transcatheter venous embolization of a massive hepatic arteriovenous shunt complicating hepatocellular carcinoma using an Amplatzer Vascular Plug. Jpn J Radiol 2011; 29:156-60. [DOI: 10.1007/s11604-010-0516-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 09/07/2010] [Indexed: 10/18/2022]
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De Santis A, Cifarelli A, Violini R. Transcatheter closure of coronary artery fistula using the new Amplatzer vascular plug and a telescoping catheter technique. J Cardiovasc Med (Hagerstown) 2010; 11:605-9. [PMID: 19680132 DOI: 10.2459/jcm.0b013e3283313504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Coronary artery fistulas (CAFs) are rare congenital or acquired anomalies characterized by an abnormal communication between the coronary arteries and the cardiac chambers or great vessels. Most patients are asymptomatic during childhood but symptoms and complications have been reported with advancing age. Until recently, surgery was the routine mode of treatment for CAFs but, today transcatheter closure is recommended using a variety of devices, such as occlusion coils, vascular plugs, umbrella devices and covered stents. The case described here is of a 47-year-old woman with a large bilateral CAF draining into the pulmonary artery, successfully treated by implantation of two Amplatzer vascular plugs using a telescoping catheter technique.
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Affiliation(s)
- Antonella De Santis
- Interventional Cardiology, Department of Cardiovascular Medicine, S. Camillo Forlanini Hospital, Rome, Italy
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35
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Zhu X, Tam MDBS, Pierce G, McLennan G, Sands MJ, Lieber MS, Wang W. Utility of the Amplatzer Vascular Plug in splenic artery embolization: a comparison study with conventional coil technique. Cardiovasc Intervent Radiol 2010; 34:522-31. [PMID: 20700592 DOI: 10.1007/s00270-010-9957-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Accepted: 07/13/2010] [Indexed: 12/18/2022]
Abstract
PURPOSE To retrospectively evaluate the role of the Amplatzer Vascular Plug (AVP) in proximal splenic artery embolization (SAE) compared with coils. MATERIALS AND METHODS Forty patients had proximal SAE performed with AVP(s) or coils as the primary embolic agent for splenic artery steal syndrome (n=23), trauma (n=5), portal hypertension (n=5), bleeding due to pancreatic pathology (n=4), and pre-splenectomy (n=3). Comparisons were made of occlusion and procedure time, cost, and radiation dose. RESULTS Eighteen proximal SAE procedures were successfully performed with AVP. Twenty-two procedures were performed with coils, including one failed AVP attempt, which was completed with coils. Precise deployment without migration was achieved in all 18 AVP cases. Seven of 22 (31.8%) coil procedures had distal migration without consequence. There was no statistically significant difference in mean occlusion time (24.4 min for AVP vs. 31.5 min for coils, P=0.13), procedure time (43.7 min for AVP vs. 53.8 min for coils, P=0.16), or cost ($1474.13 for AVP vs. $1722.51 for coils, P=0.69). There was significant difference in radiation dose (842 mGy for AVP vs. 1,309 mGy for coils, P=0.04). Fourteen of the 18 (78%) AVP devices required additional embolic material. CONCLUSIONS AVP with additional embolic agents is a useful alternative for proximal SAE because of precise deployment, resistance to migration, and radiation reduction. AVP use may be limited by vessel tortuosity. The occlusion time, procedure time, and cost were reduced but this was not statistically significant due to the need for additional embolic material.
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Affiliation(s)
- Xiaoli Zhu
- Department of Interventional Radiology, First Affiliated Hospital, Suzhou University, Suzhou, 215006, Jiangsu, China
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Libicher M, Reichert V, Schwabe H, Matoussevitch V, Gawenda M. Occlusion of arteriovenous fistulas of in-situ saphenous vein bypass grafts using the amplatzer vascular plug 4: initial experience. Cardiovasc Intervent Radiol 2010; 34:502-7. [PMID: 20440496 DOI: 10.1007/s00270-010-9882-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 04/20/2010] [Indexed: 12/01/2022]
Abstract
We examined the safety and efficacy of vessel occlusion of the Amplatzer Vascular Plug 4 (AVP-4) in patients with arteriovenous fistulas after in-situ saphenous vein bypass grafts. We treated 18 fistulas of seven patients (four women, mean±standard deviation age 76±7 years, range 63-88 years). All fistulas were detected within 14 days after surgery. Initial diagnosis and follow-up was established by sonography. We measured the diameter of the feeding vessel and the time of vessel occlusion after plug deployment. Additionally, we recorded procedure time and the dose area product. Additional interventional procedures were necessary in three patients. We successfully used 19 AVP-4 for occlusion of all fistulas without thromboembolic complications. There was no need for recapturing the device, and we did not observe dislocation. Mean occlusion time was 9.6 min (range 5-22 min). Mean diameter of the feeding vessels was 3.5 mm (range 2.6-5.1 mm). Plug sizes ranged from 4-8 mm (mean 5.5 mm) resulting in an oversizing of 33-88%. Mean procedure time for patients with and without additional intervention was 91±38 min and 35±18 min, respectively. Mean dose area product was 11,790 cGy/cm2 (range 1,850-23,500 cGy/cm2). Permanent occlusion of the fistulas was confirmed by ultrasound after a mean follow-up of 4 months (1-6 months). Occlusion of arteriovenous fistulas with an AVP-4 seems to be effective and safe in patients with in-situ saphenous vein bypass grafts. The AVP-4 is well suited for this purpose because of the appropriate diameter of the feeding vessels.
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Affiliation(s)
- Martin Libicher
- Institut und Poliklinik für Radiologische Diagnostik, Klinikum der Universität zu Köln, Kerpener Strasse 62, 50937, Cologne, Germany.
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Morris ME, Benjamin M, Gardner GP, Nichols WK, Faizer R. The Use of the Amplatzer Plug to Treat Dysphagia Lusoria Caused by an Aberrant Right Subclavian Artery. Ann Vasc Surg 2010; 24:416.e5-8. [DOI: 10.1016/j.avsg.2009.06.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 05/26/2009] [Accepted: 06/07/2009] [Indexed: 02/03/2023]
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Successful embolization of a spontaneous mesocaval shunt using the Amplatzer Vascular Plug II. Cardiovasc Intervent Radiol 2009; 33:1044-8. [PMID: 19908090 DOI: 10.1007/s00270-009-9739-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Accepted: 10/08/2009] [Indexed: 12/27/2022]
Abstract
A 48-year-old man with alcoholic liver cirrhosis and hepatic encephalopathy was found to have a large, spontaneous mesocaval shunt. The shunt was successfully occluded with the use of an Amplatzer Vascular Plug. To our knowledge, this is the first report of the use of this device to embolize a mesocaval shunt involving the superior mesenteric vein.
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Schwartz M, Glatz AC, Rome JJ, Gillespie MJ. The amplatzer vascular plug and amplatzer vascular plug II for vascular occlusion procedures in 50 patients with congenital cardiovascular disease. Catheter Cardiovasc Interv 2009; 76:411-7. [PMID: 20552654 DOI: 10.1002/ccd.22370] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
MESH Headings
- Adolescent
- Adult
- Cardiac Catheterization/adverse effects
- Cardiac Catheterization/instrumentation
- Catheterization, Peripheral/adverse effects
- Catheterization, Peripheral/instrumentation
- Child
- Child, Preschool
- Collateral Circulation
- Ductus Arteriosus, Patent/therapy
- Embolization, Therapeutic/adverse effects
- Embolization, Therapeutic/instrumentation
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/physiopathology
- Heart Defects, Congenital/therapy
- Humans
- Infant
- Infant, Newborn
- Middle Aged
- Philadelphia
- Prosthesis Design
- Retrospective Studies
- Septal Occluder Device
- Treatment Outcome
- Vascular Malformations/diagnosis
- Vascular Malformations/physiopathology
- Vascular Malformations/therapy
- Young Adult
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Affiliation(s)
- Matthew Schwartz
- The Children's Hospital of Philadelphia, Division of Cardiology, Philadelphia, PA, USA.
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Schild HH, Meyer C, Möhlenbroch M, Mueller SC, Simon B, Kuhl CK. Transrenal Ureter Occlusion with an Amplatzer Vascular Plug. J Vasc Interv Radiol 2009; 20:1390-2. [DOI: 10.1016/j.jvir.2009.06.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 05/10/2009] [Accepted: 06/14/2009] [Indexed: 12/01/2022] Open
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Ong CK, Lam DV, Ong MT, Power MA, Parkinson RJ, Wenderoth JD. Neuroapplication of Amplatzer Vascular Plug for Therapeutic Sacrifice of Major Craniocerebral Arteries: An Initial Clinical Experience. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2009. [DOI: 10.47102/annals-acadmedsg.v38n9p763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Introduction: Clinical use of the Amplatzer vascular plug in the cardiopulmonary and peripheral vasculatures has been described extensively in the literature. We present our initial experience in adapting this device for therapeutic sacrifice of major craniocerebral arteries.
Materials and Methods: Between July 2007 and November 2008, 8 patients (mean age 59.1 years; range 18 to 82 years) underwent therapeutic occlusion of major craniocerebral arteries using the device, for direct caroticocavernous fistula (1 patient), symptomatic unruptured giant cavernous internal carotid aneurysms (2 patients), and preoperative embolisation before surgical resections of skull base tumours that had encroached upon the internal carotid or vertebral artery (5 patients). The plugs were used alone or in conjunction with detachable platinum coils. The applications of the device, as well as the angiographic and clinical results of the procedures were evaluated.
Results: Applications of the plugs were straightforward and successful in all cases, with hermetic occlusions of all target arteries. When used without additional coils, several plugs were deployed in tandem to achieve complete occlusion of the artery. No migration of the device was seen. No patient developed untoward neurological deficits following the procedures, and the 3- and/or 6-month follow-up showed stable results.
Conclusion: The Amplatzer vascular plug could be a valuable addition to the neurointerventional armamentarium, particularly in therapeutic occlusion of major craniocerebral arteries. Rigidity of the delivery system limits its current use to vessels below the skull base. The potential risk of distal thromboembolism also requires further evaluation.
Key words: Amplatzer vascular plug, Craniocerebral artery, Direct caroticocavernous fistula therapeutic sacrifice, Giant aneurysms, Skull base tumours
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Affiliation(s)
- Cheng Kang Ong
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| | | | - Michelle T Ong
- Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Mark A Power
- Liverpool Hospital, Liverpool, New South Wales, Australia
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Coupe NJ, Ling L, Cowling MG, Asquith JR, Hopkinson GB. Treatment of a Common Iliac Aneurysm by Endovascular Exclusion Using the Amplatzer Vascular Plug and Femorofemoral Crossover Graft. Cardiovasc Intervent Radiol 2009; 32:772-5. [DOI: 10.1007/s00270-009-9520-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2008] [Revised: 01/09/2009] [Accepted: 01/09/2009] [Indexed: 11/29/2022]
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Bent CL, Low D, Matson MB, Renfrew I, Fotheringham T. Portal vein embolization using a nitinol plug (Amplatzer vascular plug) in combination with histoacryl glue and iodinized oil: adequate hypertrophy with a reduced risk of nontarget embolization. Cardiovasc Intervent Radiol 2009; 32:471-7. [PMID: 19194742 DOI: 10.1007/s00270-009-9515-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2008] [Revised: 01/08/2009] [Accepted: 01/09/2009] [Indexed: 12/13/2022]
Abstract
The purpose of this study was to assess whether portal vein embolization (PVE) using a nitinol vascular plug in combination with histoacryl glue and iodinized oil minimizes the risk of nontarget embolization while obtaining good levels of future liver remnant (FLR) hypertrophy. Between November 2005 and August 2008, 16 patients (8 females, 8 males; mean age, 63 +/- 3.6 years), each with a small FLR, underwent right ipsilateral transhepatic PVE prior to major hepatectomy. Proximal PVE was initially performed by placement of a nitinol vascular plug, followed by distal embolization using a mixture of histoacryl glue and iodinized oil. Pre- and 6 weeks postprocedural FLR volumes were calculated using computed tomographic imaging. Selection for surgery required an FLR of 0.5% of the patient's body mass. Clinical course and outcome of surgical resection for all patients were recorded. At surgery, the ease of hepatectomy was subjectively assessed in comparison to previous experience following PVE with alternative embolic agents. PVE was successful in all patients. Mean procedure time was 30.4 +/- 2.5 min. Mean absolute increase in FLR volume was 68.9% +/- 12.0% (p = 0.00005). There was no evidence of nontarget embolization during the procedure or on subsequent imaging. Nine patients proceeded to extended hepatectomy. Six patients demonstrated disease progression. One patient did not achieve sufficient hypertrophy in relation to body mass to undergo hepatic resection. At surgery, the hepatobiliary surgeons observed less periportal inflammation compared to previous experience with alternative embolic agents, facilitating dissection at extended hepatectomy. In conclusion, ipsilateral transhepatic PVE using a single nitinol plug in combination with histoacryl glue and iodinized oil simplifies the procedure, offering short procedural times with minimal risk of nontarget embolization. Excellent levels of FLR hypertrophy are achieved enabling safe extended hepatectomy.
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Affiliation(s)
- Clare L Bent
- Department of Diagnostic Imaging, Barts and The London NHS Trust, Whitechapel, London, E1 1BB, UK.
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Koc O, Cil BE, Peynircioglu B, Emlik D, Ozbek O. Complementary Use of NBCA with the Amplatzer Vascular Plug for Embolization of a High-Flow Traumatic Hepatic Arteriovenous Fistula. Cardiovasc Intervent Radiol 2009; 32:1105-7. [DOI: 10.1007/s00270-009-9505-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 12/24/2008] [Accepted: 01/06/2009] [Indexed: 10/21/2022]
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Embolization of the Gastroduodenal Artery Before Selective Internal Radiotherapy: A Prospectively Randomized Trial Comparing Platinum-Fibered Microcoils with the Amplatzer Vascular Plug II. Cardiovasc Intervent Radiol 2009; 32:455-61. [DOI: 10.1007/s00270-008-9498-y] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2008] [Revised: 11/18/2008] [Accepted: 11/26/2008] [Indexed: 12/20/2022]
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Kenny D, Walsh KP. Transcatheter occlusion of a classical BT shunt with the Amplatzer Duct Occluder II. Catheter Cardiovasc Interv 2008; 72:841-3. [DOI: 10.1002/ccd.21718] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Vandy F, Criado E, Upchurch GR, Williams DM, Rectenwald J, Eliason J. Transluminal hypogastric artery occlusion with an Amplatzer vascular plug during endovascular aortic aneurysm repair. J Vasc Surg 2008; 48:1121-4. [PMID: 18692350 DOI: 10.1016/j.jvs.2008.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/15/2008] [Accepted: 06/01/2008] [Indexed: 11/26/2022]
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Transcatheter Closure of a Chronic Iatrogenic Arteriovenous Fistula Between the Carotid Artery and the Brachiocephalic Vein with an Amplatzer Duct Occluder in Combination with a Carotid Stent. Cardiovasc Intervent Radiol 2008; 32:568-71. [DOI: 10.1007/s00270-008-9438-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2008] [Revised: 08/26/2008] [Accepted: 08/27/2008] [Indexed: 10/21/2022]
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Hwang HK, Tsai YS, Lin SM, Chen MR. Occlusion of an aberrant artery to an intralobar pulmonary sequestration using an Amplatzer Vascular Plug. Pediatr Pulmonol 2008; 43:933-5. [PMID: 18668690 DOI: 10.1002/ppul.20882] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Pulmonary sequestration is a rare anomaly and is conventionally treated with surgical excision. This report describes the successful occlusion of a large aberrant artery to an intralobar pulmonary sequestration using an Amplatzer Vascular Plug.
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Affiliation(s)
- Haw-Kwei Hwang
- Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan
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50
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Outcomes of Amplatzer Vascular Plugs for Occlusion of Internal Iliacs during Aortoiliac Aneurysm Stent Grafting. Ann Vasc Surg 2008; 22:613-7. [DOI: 10.1016/j.avsg.2008.01.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2007] [Revised: 10/27/2007] [Accepted: 01/03/2008] [Indexed: 11/18/2022]
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