AMPLATZER Vascular Plug 4 for Proximal Splenic Artery Embolization in Blunt Trauma

Ng, Edmund H.; Comin, Jules; David, Elizabeth; Pugash, Robyn; Annamalai, G.

doi:10.1016/j.jvir.2012.04.009

Cited by 16 publications

(13 citation statements)

References 8 publications

(12 reference statements)

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“…Of the 44 studies, 12 were excluded without follow-up [ 1 , 12 , 15 , 17 , 20 – 23 , 37 – 40 ], and 9 studies were excluded because of the lack of detailed data about SAE techniques [ 19 , 29 , 31 , 41 – 46 ]. Finally, 23 relevant studies [ 7 , 10 , 11 , 16 , 25 – 28 , 30 , 32 , 47 – 59 ] were included as 1st study set. Then, 13 studies in 1st study set were excluded with significant differences of grades of AAST-OIS and the remaining 10 studies were included in 2nd study set (Flow diagram shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The average age in included studies was 38.8 ± 5.4 years (range 16–89) and most of the patients were male (72.4%, range 57.9–92.9%). The contrast blush (38.4%) or pseudoaneurysm (8.2%), high-grade (AAST III-V) splenic injury (50.1%), and large hemoperitoneum (18.0%) were widely considered as major indications for embolization after splenic injury [ 4 , 7 , 10 , 11 , 25 – 27 , 30 , 32 , 47 – 51 , 53 – 55 , 57 ]. More than one indication per patient could occur and the distribution of these individual indications for embolization differed significantly in studies (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Proximal embolization was performed more often than distal and combined significantly (52.1% vs 24.8% vs 5.5%). Exclusively proximal embolization, distal embolization and combination were performed in 5 studies [ 44 , 48 , 50 , 52 , 54 ], 1 study [ 10 ] and 10 studies [ 7 , 11 , 27 , 28 , 30 , 47 , 53 , 55 , 56 , 58 ] (Table 4 ). On embolization materials, coil and gelfoam were commonly used materials in included studies.…”

Section: Resultsmentioning

confidence: 99%

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The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

et al. 2017

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BackgroundSplenic artery embolization (SAE) has been an effective adjunct to the Non-operative management (NOM) for blunt splenic injury (BSI). However, the optimal embolization techniques are still inconclusive. To further understand the roles of different embolization locations and embolic materials in SAE, we conducted this system review and meta-analyses.MethodsClinical studies related to SAE for adult patients were researched in electronic databases, included PubMed, Embase, ScienceDirect and Google Scholar Search (between October 1991 and March 2013), and relevant information was extracted. To eliminate the heterogeneity, a sensitivity analysis was conducted on two reduced study sets. Then, the pooled outcomes were compared and the quality assessments were performed using Newcastle-Ottawa Scale (NOS). The SAE success rate, incidences of life-threatening complications of different embolization techniques were compared by χ 2 test in 1st study set. Associations between different embolization techniques and clinical outcomes were evaluated by fixed-effects model in 2nd study set.ResultsTwenty-three studies were included in 1st study set. And then, 13 of them were excluded, because lack of the necessary details of SAE. The remaining 10 studies comprised 2nd study set, and quality assessments were performed using NOS. In 1st set, the primary success rate is 90.1% and the incidence of life-threatening complications is 20.4%, though the cases which required surgical intervention are very few (6.4%). For different embolization locations, there was no obvious association between primary success rate and embolization location in both 1st and 2nd study sets (P > 0.05). But in 2nd study set, it indicated that proximal embolization reduced severe complications and complications needed surgical management. As for the embolic materials, the success rate between coil and gelfoam is not significant. However, coil is associated with a lower risk of life-threatening complications, as well as less complications requiring surgical management.ConclusionsDifferent embolization techniques affect the clinical outcomes of SAE. The proximal embolization is the best option due to the less life-threatening complications. For commonly embolic material, coil is superior to gelfoam for fewer severe complications and less further surgery management.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

et al. 2017

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“…This eliminates the need for catheter exchanges and allows delivery and deployment of the device in smaller, remote, and extremely tortuous vessels as demonstrated in our patient. While the AVP-IV has been used for occlusion of arteriovenous fistulas after saphenous vein harvesting, coronary artery fistulas and aortopulmonary collaterals, intercostal arteries from left internal mammary bypass grafts, and for a variety of peripheral indications,[11121314] to the best of our knowledge, this is the first case of embolization of three PAVMs with AVP-IV devices. Similar to other reports we found that only a single AVP-IV device was adequate to achieve complete and rapid occlusion of the vessel.…”

Section: Discussionmentioning

confidence: 99%

Amplatzer vascular plug IV for occlusion of pulmonary arteriovenous malformations in a patient with cryptogenic stroke

2014

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Paradoxical embolism resulting in cryptogenic stroke has received much attention recently, with the primary focus on patent foramen ovale (PFO). However, it is essential to be vigilant in the search for other causes of paradoxical embolic events, such as pulmonary arteriovenous malformations (PAVM). We describe successful closure of pulmonary AVM with a St Jude Medical (Plymouth, MN) Amplatzer™ vascular plug IV. The newer AVP-IV devices can be used for successful embolization of tortuous pulmonary AVM in remote locations where use of other traditional devices may be technically challenging.

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“…2,26 The AVP has been used for SA embolization in cases of trauma, hypersplenism, the treatment of portal hypertension complications, and SA steal syndrome. 2,6,7,10,[26][27][28] The main challenge occurs in those patients with very tortuous SA where advancing the delivery sheath can be very difficult. 2 The mean occlusion time was on average 10 minutes for patients with SA syndrome and trauma.…”

Section: Splenic Artery Embolizationmentioning

confidence: 99%

The Amplatzer Vascular Plug: Review of Evolution and Current Applications

Lopera

2015

Semin intervent Radiol

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The Amplatzer Vascular Plug (AVP) was created for peripheral embolization as a modification of the family of Amplatz septal occluders used in the treatment of congenital heart malformations. The device has evolved over the years and multiple versions have been launched into the market. Each of the versions of the device has some important modifications in terms of the size of the introducer's system, number of layers, and resultant thrombogenicity. It is very important for the operator to become familiar with the unique features of the AVP, and to understand the advantages and limitations of each model in the AVP family to achieve an optimal embolic result. The purpose of this article is to review the evolution and current clinical applications of the AVP in the field of interventional radiology, with emphasis on the advantages and limitations of this device in comparison with other embolization agents.

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AMPLATZER Vascular Plug 4 for Proximal Splenic Artery Embolization in Blunt Trauma

Cited by 16 publications

References 8 publications

The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

The impacts of different embolization techniques on splenic artery embolization for blunt splenic injury: a systematic review and meta-analysis

Amplatzer vascular plug IV for occlusion of pulmonary arteriovenous malformations in a patient with cryptogenic stroke

The Amplatzer Vascular Plug: Review of Evolution and Current Applications

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