The use of the Amplatzer Vascular Plug in the prevention of endoleaks during abdominal endovascular aneurysm repair: A systematic literature review on current applications

Abstract

Objectives The Amplatzer Vascular Plug (AVP) is a vascular occlusion device designed to provide optimal embolization in several fields of the endovascular surgery. A full literature review was conducted to analyze AVPs in comparison with coils for the prevention of endoleaks during endovascular abdominal aortic aneurysm repair. Methods A systematic review was designed under PRISMA statement guidelines for systematic reviews and meta-analyses. The results were updated with a subsequent electronic search using Medline and Scopus databases up to December 2019. Results Eighteen articles making this comparison were found. In 79.7% of the cases, the target vessel was the internal iliac artery; in 1.6%, the common iliac artery; and in 16.7%, the inferior mesenteric artery. Risk of complications (buttock claudication, groin hematoma, endoleaks, and erectile dysfunction) after AVP was low. A cost comparison revealed that the mean cost for coils was around US$2262, while the average cost for the AVP was US$310. Conclusions The AVP is an effective and safe device for occluding peripheral vessels, proved to have lower complications rates. Compared with coil embolization, the AVP technique is potentially associated with lower procedural costs.

Endovascular treatment of a wide-necked renal artery aneurysm with a flow diverter stent

“…Exclusion of RAA through stents and embolization is characterized by success rates of 73%-100% and variable complication rates of 13%-60%. As well, embolization with coils, onyx or plugs can be used to reduce risk of bleeding as a prior step to open surgery or as a useful combined 1 step therapeutic strategy [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] .…”

Plug-Based Embolization Techniques of Aortic Side Branches during Standard and Complex Endovascular Aortic Repair

“…In this setting, plugs seem to be safer than coils in achieving complete occlusion with lower rates of complications as it has been reported that plugs have lower rates of buttock claudication and erectile dysfunction [50,51]. When the sealing zone length is scarce, a short plug such as the AVP should be preferred to a longer plug such as the AVPII, which is chosen in cases of normal length [52]. Proximal positioning of the plug must be avoided in case of aneurysmatic IIA, in which cases the backflow through terminal branches could promote sac enlargement in the IIA.…”

Transcatheter Embolization in Congenital Cardiovascular Malformations—Variable Use of Vascular Plugs

“…Various mechanical devices are available for endovascular embolization, such as septal occluders, coils, and vascular plugs. Amplatzer™ Vascular Plugs (AVPs) (Abbott Medical, Plymouth, MN, USA) are self-expanding nitinol devices which can be used for a wide range of acquired and congenital diseases [1][2][3][4][5][6][7]. Configuration and characteristics of these devices are well described [4,8].…”