A Novel Use of the AMPLATZER Vascular Plug: Preventing Bile Leak Following Inadvertent Subcapsular Deployment of a Biliary Stent

Abstract

The AMPLATZER Vascular Plug (AVP; AGA Medical, USA) is designed to provide optimal embolization of peripheral veins and arteries through single-device occlusion. There are no reported cases of the AVP's being used to prevent bile leak. We report the successful use of the AVP within the liver to prevent intraperitoneal bile leak following inadvertent subcapsular stent deployment.

Use of Amplatzer Vascular Plug to Treat a Biliary Cutaneous Fistula

“…We opted to use an AVP in this case, for its mechanical occlusion effect. Further, as other colleagues prior postulated (13), the richly vascular liver would provide an adequate environment for clotting, and therefore occlusion, to occur. As the patient remained well and the follow-up CT scan demonstrated no evidence of leak, we were reassured that the device provided adequate occlusion.…”

“…Endobronchial closure of a small postoperative bronchopulmonary fistula using the AVP was recently reported as a safe and effective treatment (10). AVP has also been used for the treatment ofesophago-pleural fistulae (assisted with endoscopy) (11), ureteral occlusion for vescicovaginal fistula (12), and treatment of intraperitoneal bile leak (13). …”

Bilateral transrenal ureteral occlusion by means of n-butyl cyanoacrylate and AMPLATZER vascular plug

“…In facts, its main use is related to the occlusion of cardiac septal defects and, to a lesser extent, in the treatment of other disease-related complications such as bile leaks. [78]…”

The Amplatzer Vascular Plug: Review of Evolution and Current Applications

“…The AVP has been very successful in preventing percutaneous access complications, but the cost of the device compared with that of other embolic agents and the risk of infectious complications, as a permanent foreign body is left in place, needs to be considered before its routine use. 68,69…”