The amplatzer vascular plug and amplatzer vascular plug II for vascular occlusion procedures in 50 patients with congenital cardiovascular disease

Schwartz, M. William; Glatz, Andrew C.; Rome, Jonathan J.; Gillespie, Matthew J.

doi:10.1002/ccd.22370

Cited by 62 publications

(86 citation statements)

References 25 publications

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“…In the literature we have found that transcatheter closure of PDA with AVPII was described only in children (the oldest one was 4 years old) [8,9]. We have confirmed that the Amplatzer plug II is also useful for closure of a relatively large elongated type of PDA in an adult patient.…”

Section: Discussionsupporting

confidence: 52%

“…Using the AVPII we found that the device was easily delivered through a small catheter (6 F) into the centre of the duct, leading to complete occlusion without obstruction of the aorta or the left pulmonary artery. The approach to AVPII delivery was to have all discs contained within the ductus when possible or (as in our case) to have two discs within the duct and one disc opened in the pulmonary artery [9]. Such a strategy was due to the presence of the relatively long PDA (20 mm).…”

Section: Discussionmentioning

confidence: 99%

“…This relatively new device has been used successfully for closure of collateral vessels associated with single ventricle repair, transhepatic fistula and surgical Ao-PA shunts [4,5]. It has also been used for percutaneous PDA closure [6][7][8][9], but the number of such reports is limited and the results contradictory [5,10].…”

Section: Introductionmentioning

confidence: 99%

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Use of an Amplatzer Vascular Plug type II to occlude elongated patent ductus arteriosus in adult patient

Heredia¹,

Szkutnik²,

Fiszer³

et al. 2012

pwki

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A b s t r a c tPatent ductus arteriosus (PDA) is one of the most prevalent congenital heart diseases. Transcatheter closure of PDA is the treatment method of choice. In spite of recent advances in transcatheter management, the occlusion of certain anatomical types of PDA remains a challenge. The aim of the study was to report novel use of the Amplatzer Vascular Plug type II (AVPII) for closure of large elongated type of PDA (type E according to Krichenko classification) in a 19-year-old man. In clinical examination a soft continuous murmur was heard in the 2-3 left intercostal space. Echocardiography confirmed left to right shunt through the PDA. Left ventricle and left atrium were at the upper limit for body weight. In angiography the duct was 20 mm long, 7 mm wide with 3 mm narrowing at the pulmonary end. For the procedure we applied a 12 mm AVPII. The AVPII is a self-expanding, nitinol wire mesh occluder dedicated for arterial and venous occlusion in the peripheral circulation. It was delivered through a 6 F catheter retrogradely. The distal disc and medial part of the AVPII were opened inside the duct, and the proximal disc in the pulmonary artery. Complete closure of the PDA was confirmed in angiography. No complications during the procedure or 3-month follow-up were observed. Application of the AVPII is a safe and effective method of treatment for adult patients with elongated type of PDA.Key words: device closure, patent ductus arteriosus S t r e s z c z e n i e Przetrwały przewód tętniczy (patent ductus arteriosus -PDA) jest częstą wrodzoną wadą serca, a przezcewnikowe zamykanie tej struktury -leczniczym postępowaniem z wyboru. Pomimo niewątpliwego postępu obserwowanego w kardiologii interwencyjnej, zamykanie niektórych anatomicznych postaci PDA pozostaje wyzwaniem. Celem pracy jest przedstawienie przypadku mężczyzny w wieku 19 lat, u którego PDA typu wydłużonego (według kwalifikacji Kirchenko -typ E) zamknięto przy zastosowaniu nowatorskiej metody, używając do tego celu Amplatzer Vascular Plug typ II (AVPII). W badaniu klinicznym stwierdzano u pacjenta ciągły szmer w 2-3 przestrzeni międzyżebrowej. Echokardiografia potwierdziła lewo-prawy przeciek na poziomie PDA. Wymiary lewej komory i lewego przedsionka były w górnych granicach normy dla masy ciała. W angiografii przewód tętniczy miał następujące wymiary: 20 mm długości, 7 mm średnicy i 3-milimetrowe zwężenie przy końcu płucnym. Do przezcewnikowego zamknięcia zastosowano AVPII 12 mm. AVPII jest samorozprężającym się implantem, wykonanym z siatki z nitynolowego drutu, stosowanym zwykle do zamykania nieprawidłowych połączeń w obwodowym układzie krążenia. Był on dostarczony odżylnie za pomocą cewnika 6 F. Dystalny dysk i środ-kową część AVPII otworzono w PDA, a proksymalny dysk w tętnicy płucnej. W kontrolnej angiografii stwierdzono całkowite zamknię-cie PDA. Nie obserwowano żadnych powikłań okołozabiegowych oraz w 3-miesięcznej obserwacji. Zastosowanie AVPII u dorosłego pacjenta z PDA typu wydłużonego jest bezpieczną i skuteczną metodą leczenia.Słowa kl...

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of an Amplatzer Vascular Plug type II to occlude elongated patent ductus arteriosus in adult patient

Heredia¹,

Szkutnik²,

Fiszer³

et al. 2012

pwki

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“…There are reports of perventricular approaches to close the pulmonary artery stump [8] as well as multiple publications describing vascular occluders for other indications including AV malformations, aorto-pulmonary collaterals, and coronary fistula [9].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Retrograde Device Closure of an Isolated Pulmonary Valve Stump Using a Deflectable Sheath Technique

Rhodes¹,

Green²,

Jaquiss³

2017

jshd

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Patients with a single ventricular heart physiology may have a persistent egress through one of the semilunar valves that was surgically closed during the palliative operations. This semi lunar patency results in a blind ending pulmonary artery stump. Consequently, the patient is at risk for thrombus that can then result in a paradoxical embolic event and potentially an ischemic stroke. Patients therefore must undergo a reoperation to close the stump or remain on anticoagulation for lifetime. This report demonstrates the use of a retrograde arterial approach and a deflectable delivery sheath to obliterate the proximal pulmonary valve with a vascular device.

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“…All four types of AVP have two components: a vascular plug and a delivery wire. The plugs have radiopaque platinum marker bands at both ends (4). The AVP 2 contains a more densely woven nitinol mesh and minimizes migration and recanalization (5).…”

mentioning

confidence: 99%

Applications of the Amplatzer Vascular Plug to various vascular lesions

Güneyli

Çınar²,

Bozkaya³

et al. 2013

Diagn Interv Radiol

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The Amplatzer ® Vascular Plug (AVP) can be used to embolize medium-to-large high-flow vessels in various locations. Between 2009 and 2012, 41 AVPs (device size, 6-22 mm in diameter) were used to achieve occlusion in 31 patients (24 males, seven females) aged 9-92 years (mean age, 54.5 years). The locations and indications for embolotherapy were as follows: internal iliac artery embolization before stent-graft repair for aorto-iliac (n=6) and common iliac artery (n=3) aneurysms, subclavian artery embolization before stent-graft repair for thoracic aorta (n=3) and arcus aorta (n=1) aneurysms, brachiocephalic trunk embolization before stent-graft repair for a thoracic aorta aneurysm (n=1), embolization of aneurysms and pseudoaneurysms (n=5), embolization for carotid blow-out syndrome (n=3), closure of arteriovenous fistula (n=8), and closure of a portosystemic fistula (n=1). Of the 41 AVPs, 30 were AVP 2 and 11 were AVP 4. The mean follow-up duration was 4.7 months (range, 1-24 months). During follow-up, there was one migration, one insufficient embolization, and one recanalization. The remaining vascular lesions were successfully excluded from the circulation. The AVP, which can be used in a wide spectrum of pathologies, is easy to use and causes few complications. This essay presents our experience with the AVP. T he Amplatzer® Vascular Plug (AVP, AGA Medical Corp., Golden Valley, Minnesota, USA) is a good alternative to other embolic materials (1). The AVP has many advantages over embolic materials such as coils or glue. It is retractable, and it can be repositioned. Use of the AVP has cost advantages over other embolic materials. It can be used safely in trauma patients or in patients before endovascular aortic repair (EVAR). It ensures permanent occlusion, and its migration risk is less than for coils. The results of embolization with the AVP have been excellent (2), and no contraindications for its use have been reported (3). All four types of AVP have two components: a vascular plug and a delivery wire. The plugs have radiopaque platinum marker bands at both ends (4). The AVP 2 contains a more densely woven nitinol mesh and minimizes migration and recanalization (5). The AVP 4 is used mostly in small, tortuous vessels (6). The AVP is made of self-expanding material, and it returns to its original shape after release from the catheter. It has a long delivery cable, is preloaded in a loader, and is delivered through guiding catheters ranging from 5 to 8 F in size. The AVP is released by rotating the delivery cable counterclockwise.Thirty-one patients (24 males, seven females) aged 9-92 years (mean age, 54.5 years), who underwent percutaneous occlusion with the AVP at our hospital between 2009 and 2012, were evaluated retrospectively. Patients with any pathology involving AVP use for embolization were included in this study. Patients in whom only other embolic materials were used were excluded. The study was approved by the Institutional Review Board and consent was obtained from the patients before th...

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The amplatzer vascular plug and amplatzer vascular plug II for vascular occlusion procedures in 50 patients with congenital cardiovascular disease

Abstract: Plugs 1 and 2 are safe and effective devices that can be used in a variety of blood vessels in patients with CCVD. Plug 2 is particularly useful in closure of high-flow, tubular structures, especially type C PDA's.

Cited by 62 publications

References 25 publications

Use of an Amplatzer Vascular Plug type II to occlude elongated patent ductus arteriosus in adult patient

Use of an Amplatzer Vascular Plug type II to occlude elongated patent ductus arteriosus in adult patient

Transcatheter Retrograde Device Closure of an Isolated Pulmonary Valve Stump Using a Deflectable Sheath Technique

Applications of the Amplatzer Vascular Plug to various vascular lesions

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