Applications of amplatzer® vascular plug 4

Yıldız, Attila; Peynircioğlu, Bora; Çil, Barbaros

doi:10.4261/1305-3825.dir.4410-11.1

Cited by 8 publications

(7 citation statements)

References 10 publications

(21 reference statements)

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“…We prefer the AVP 4 over AVP 1. This new device can be deployed through a 4 F diagnostic catheter, which is a major advantage of this device, especially in pediatric populations (12). However, it was not available at our hospital.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous embolization of carotico-azygous fistula with amplatzer vascular plug-i

Öztürk

Ödemiş²,

Güzeltaş³

et al. 2011

Diagn Interv Radiol

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431C arotico-azygous fistula is an extremely rare form of arteriovenous fistula, resulting from an abnormal communication between the carotid artery and azygous vein (1-4). As a result of continuous murmur, which is a typical physical finding of these vascular malformations, a caroticoazygous fistula could be confused with patent ductus arteriosus. Transcatheter coil embolization of these fistulas has been reported previously (5).Here, we describe a five-year-old boy with caroticoazygous fistula, who also had patent ductus arteriosus, the main cause of misdiagnosis, and successful transcatheter embolization with the Amplatzer ® Vascular Plug 1 (AVP 1). Case reportA five-year-old boy was referred to our clinic with cardiac murmur. He had no history of any complaint. During physical examination, a continuous murmur was heard in the left chest area. Electrocardiogram and telecardiography were normal. Color and continuous wave Doppler echocardiography showed patent ductus arteriosus with dilated left atrium and left ventricle. Left atrium-to-aortic root diameter ratio was 1.7. He underwent cardiac catheterization and descending aorta angiography, focusing only on possible patent ductus arteriosus arising from the aorta. Patent ductus arteriosus was detected by angiography. The narrowest diameter of patent ductus arteriosus was measured as 2.3 mm. A detachable coil, 5 mm in diameter and having five loops (William Cook Europe, Bjaeverskov, Denmark), was used for occlusion of patent ductus arteriosus. No residual shunt was observed in control angiography (Fig. 1). During examination on the next day, a continuous murmur was still heard in the same area, but no residual shunt was detected by echocardiography. A chest X-ray confirmed that the coil had not migrated. We then highly suspected an arteriovenous fistula but it was not revealed by echocardiography. Therefore, other reasons for the continuous murmur were investigated. Initially, cranial computed tomography with contrast and abdominal Doppler ultrasound were performed to reveal a fistula in those areas, but the results were normal. We then decided to perform further cardiac catheterization. During the second cardiac catheterization procedure, aortic angiography detected a fistula tract between the carotid artery and azygous vein (Fig. 2).Aortic and subsequent selective angiography in anteroposterior and lateral views showed multiple branches of the vertebral arteries linking the fistula tract. It had a tortuous course, and the narrowest part measured 3.4 mm (Fig. 2). The calculated pulmonary to systemic blood flow ratio was 1.7.Lateral selective descending angiography was performed to delineate the fistula tract (Fig. 2a). The fistula tract had several connections to ABSTRACT We present the case of a five-year-old boy with a caroticoazygous fistula, which is an extremely rare congenital vascular malformation. The patient also had patent ductus arteriosus, a common cause of continuous murmur. The murmur continued despite successful coil embolization of the ductus. ...

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Section: Discussionmentioning

confidence: 99%

Percutaneous embolization of carotico-azygous fistula with amplatzer vascular plug-i

Öztürk

Ödemiş²,

Güzeltaş³

et al. 2011

Diagn Interv Radiol

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“…Occluding devices may be more expensive than single coils, but they are cheaper when the use of multiple items is taken into account. The advantages of these devices are their rapid deployment, their small-diameter catheter delivery systems, and their precisely targeted placement, with repositioning or removal easily achieved; device migration may still occur, however (3,4). Amplatzer devices are permanent vascular occlusion devices made of ninitol mesh and are designed to cause vessel thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Occlusion of a neo-esophageal-bronchial fistula using the Amplatzer Vascular Plug 2

Young

Shimi²,

Alijani³

et al. 2012

Diagn Interv Radiol

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The appearance of a benign fistula between the airway and the gastrointestinal tract is a rare complication of esophagectomy. We report a patient with neo-esophago-bronchial fistula that developed 13 months after two-stage esophagectomy. Repeat thoracotomy was not deemed appropriate given the patient's chronic sepsis and malnutrition. After unsuccessful attempts at endoscopic closure, the fistula was successfully and permanently occluded under radiological guidance with an Amplatzer ® Vascular Plug 2. The patient remained asymptomatic, with a measured weight gain, 12 months after the successful fistula occlusion.

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“…Based on experience in peripheral and cardiac interventions, vessel occlusion devices have been used for cranial vessels [16,17]. Studies have shown effective embolization with the Amplatzer Vascular Plug used in conjunction with coils for the treatment of cavernous carotid aneurysm and pulmonary arteriovenous fistulas [18,19].…”

Section: Discussionmentioning

confidence: 99%

High-Flow Carotid Cavernous Fistula and the Use of a Microvascular Plug System: Initial Experience

et al. 2014

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Purpose: We report our initial experience using a detachable microvascular plug system to occlude the internal carotid artery during endovascular treatment of high-flow carotid cavernous fistula. Case and Technique: An 87-year-old patient was admitted for acute-onset double vision with associated right-eye ptosis. Exam revealed a pupil-sparing, partial right third cranial nerve palsy. MRI showed a carotid cavernous fistula with high-flow drainage. Digital subtraction angiography showed a high-flow, right-sided, direct carotid cavernous fistula with flow from the proximal right internal carotid artery. The ophthalmic artery, posterior communicating artery and anterior communicating arteries supplied retrograde flow to the fistula through the internal carotid artery. Obliteration of the fistula was achieved through coil embolization in combination with proximal and distal microvascular plugs (Reverse Medical, Irvine, Calif., USA). Conclusion: The microvascular plug is a new addition to current endovascular embolization devices for the treatment of high-flow, direct carotid cavernous fistulas. This technique offers easy navigability through tortuous arteries, precise localization and immediate occlusion, which may allow shorter procedure and fluoroscopy times and increased cost-effectiveness. Larger case series are needed to support our observation.

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Applications of amplatzer® vascular plug 4

Cited by 8 publications

References 10 publications

Percutaneous embolization of carotico-azygous fistula with amplatzer vascular plug-i

Percutaneous embolization of carotico-azygous fistula with amplatzer vascular plug-i

Occlusion of a neo-esophageal-bronchial fistula using the Amplatzer Vascular Plug 2

High-Flow Carotid Cavernous Fistula and the Use of a Microvascular Plug System: Initial Experience

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