The AMPLATZER Vascular Plug 4: Preliminary Experience

Abstract

The purpose of this communication is to describe our preliminary experience with the Amplatzer Vascular Plug 4 (AVP 4) in peripheral vascular embolization. The AVP 4 was used for peripheral vascular embolization in five patients with renal pseudoaneurysm (n = 2), postsurgical peritoneal bleeding (n = 1), posttraumatic gluteal hemorrhage (n = 1), and intercostal pseudoaneurysm (n = 1). Occlusion time was recorded. Patients were followed up clinically and by imaging for 1 month after the procedure. All treated vessels or vascular abnormalities were successfully occluded within 3 min for low-flow circulation and over 8 min for high-flow circulation. At 1-month follow-up, all patients were symptom-free. All deployed devices remained in the original locations and desirable configurations. In conclusion, the AVP 4 seems to be safe and effective for occluding peripheral vessels and vascular abnormalities. Because of its compatibility with 0.038-in. catheters, it can be deployed through a diagnostic catheter following angiography without exchanging a sheath or guiding catheter. Compared with the previous generation of vascular plugs, the AVP 4 allows for faster procedure times and decreased exposure to radiation.

Applications of amplatzer® vascular plug 4

“…Therefore, in most cases, a single plug is sufficient for complete vessel occlusion. The use of one plug results in a significant reduction in the number of procedural steps, which in turn results in lower radiation exposure, reduced procedure time, and lower complication rates (1)(2)(3)(4)(5)(6)(7)(8).…”

“…The English literature describes the utility of the AVP 4 in renal pseudoaneurysm, postsurgical peritoneal bleeding, posttraumatic gluteal hemorrhage, intercostal pseudoaneurysm, and arteriovenous fistula after in situ saphenous vein bypass grafts (1)(2)(3)(4)(5)(6)(7)(8).…”

“…The AVP 4 is available in 11-mm lengths with diameters ranging from 4 to 8 mm in 1-mm increments. It is recommended to select a device approximately 30%-50% larger than the vessel diameter (1)(2)(3).…”

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

“…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].…”

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

“…The use of the AMPLATZER Vascular Plug (AVP) (St. Jude Medical, Inc, St. Paul, Minnesota) compared with pushable coils has shown similar high technical success rates with low complication rates in the literature (3)(4)(5)(6). The ability to recapture and reposition the device provides an added benefit of the AVP over pushable coils.…”