Use of the Amplatzer Vascular Plug® for treatment of coronary steal

Weinberg, Nicole; French, William J.; Shavelle, David M.

doi:10.1016/j.ijcard.2006.11.203

Cited by 9 publications

(7 citation statements)

References 14 publications

(15 reference statements)

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“…Further, vascular plugs may be more suitable in medium or large side branches when there is concern for coil dislodgement or uncoiling 49 . In five case reports involving AVP deployment for LIMA side branch coronary steal ( N = 5 patients), four were technically successful with relief of stable angina and the fifth was associated with an inadvertent side branch dissection that ultimately occluded the vessel and relieved symptoms 6,37,38,41,50 …”

Section: Therapeutic Interventionsmentioning

confidence: 99%

“…49 In five case reports involving AVP deployment for LIMA side branch coronary steal (N = 5 patients), four were technically successful with relief of stable angina and the fifth was associated with an inadvertent side branch dissection that ultimately occluded the vessel and relieved symptoms. 6,37,38,41,50 4.3 | Covered stent within the LIMA A third percutaneous option described is deployment of a covered stent within the LIMA at the ostium of the side branch to prevent branch flow. 40 However, based on limited data, the restenosis rate of covered stents are as high as 31.6% at a mean 159-day follow-up.…”

Section: Amplatzer Vascular Plugmentioning

confidence: 99%

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Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

Mangels

Penny

Reeves

2019

Cathet Cardio Intervent

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Objective: The objective of this qualitative review is to summarize the pathophysiological and clinical data behind the clinical entity of left internal mammary artery (LIMA) side branch coronary steal as well as the potential diagnostic and therapeutic modalities available. Background: The presence of persistent unligated LIMA side branches following coronary artery bypass grafting has previously been associated with stable angina and acute coronary syndromes. However, despite numerous attempts to objectively demonstrate a coronary steal phenomenon, the pathophysiology of LIMA side branch flow diversion remains elusive and the clinical utility of intervention is not well elucidated. Methods: A review of literature and available data including case reports, case series, and investigational studies was performed. Results: Therapeutic closure of LIMA side branches has been reported in at least 44 patients and in at least 31 publications since 1990 and is associated with an 87.5% rate of freedom from angina amongst technically successful initial interventions. In all patients with pre-and post-stress testing, intervention was associated with an improvement and/or resolution of previously observed reversible ischemia. Conclusions: LIMA side branch coronary steal should remain an ongoing consideration in symptomatic patients with large unligated side branches on angiography, particularly when there is clear evidence of reversible ischemic on perfusion imaging.

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Section: Therapeutic Interventionsmentioning

confidence: 99%

Section: Amplatzer Vascular Plugmentioning

confidence: 99%

Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

Mangels

Penny

Reeves

2019

Cathet Cardio Intervent

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“…If objective evidence for ischemia exists, a variety of devices, including coil embolization, have been used in the percutaneous treatment of LIMA side branch induced coronary steal [Cay 2008]. It remains controversial whether proximal side branches that originate from a LIMA graft can cause a coronary steal phenomenon and ischemia in the left anterior descending (LAD) artery distribution [Weinberg 2008]. Initial case reports describing the benefi ts of occlusion of LIMA side branches focused solely on the resolution of clinical symptoms to justify this as a distinct clinical syndrome [Weinberg 2008].…”

Section: Introductionmentioning

confidence: 99%

“…It remains controversial whether proximal side branches that originate from a LIMA graft can cause a coronary steal phenomenon and ischemia in the left anterior descending (LAD) artery distribution [Weinberg 2008]. Initial case reports describing the benefi ts of occlusion of LIMA side branches focused solely on the resolution of clinical symptoms to justify this as a distinct clinical syndrome [Weinberg 2008]. We recently used the Embolization Coil-IMWCE-3-PDA5 (Cook Medical, Bjaeverskov, Denmark) to occlude a large LIMA side branch in a symptomatic patient with presumed coronary steal.…”

Section: Introductionmentioning

confidence: 99%

The Unligated Left Internal Mammary Artery Side Branch as the Cause of Angina after Coronary Artery Bypass Grafting

Peruga

Bielecka‐Dąbrowa²,

Kasprzak³

2012

HSF

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The left internal mammary artery (LIMA) is a widely used conduit during coronary artery bypass graft (CABG) surgery because of its excellent long-term patency. Although large LIMA side branches are typically ligated during the surgery, the occurrence of a coronary steal phenomenon related to these side branches following surgery remains controversial. Advocates for occlusion of LIMA side branches in the setting of left anterior descending artery (LAD) ischemia indicate that anginal symptoms often improve and that objective measures of LAD ischemia frequently resolve. We present a patient with ischemia in the LAD distribution secondary to coronary steal from a large LIMA side branch that was successfully treated using the Embolization Coil-IMWCE-3-PDA5 (Cook Medical, Bjaeverskov, Denmark).

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“…It received approval for use as an occlusive device in peripheral vasculature in 2004. The use of the AVP has been described in a variety of clinical settings such as the treatment of pulmonary arterio-venous malformations, coronary artery fistulas, patent ductus arteriosus, aortopulmonary collaterals, ruptured coronary artery aneurysm, subclavian and internal iliac artery occlusion in endovascular aneurysm repair (EVAR), hepatic hemangioma, saphenous vein graft aneurysm, renal tumours, transjugular intrahepatic portosystemic shunt (TIPS) closure, porto caval shunt closure and treatment of coronary steal [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Although a wide variety of uses has been reported, the numbers are relatively small for individual indications.…”

Section: Introductionmentioning

confidence: 99%

The Amplatzer vascular plug for large vessel occlusion in the endovascular management of aneurysms

et al. 2008

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The Amplatzer vascular plug (AVP) is derived from the Amplatzer device used in correction of cardiac septal defects. We present a large series of the use of the AVP in the endovascular management of aneurysms. Three patients with a combination of aortic and peripheral aneurysms underwent embolisation with the AVP. Plugs with 10-16 mm diameter were used and delivered using introducer/guiding sheaths. A total of 16 internal iliac arteries, 2 common iliac arteries (CIA), 4 subclavian (SCA) arteries, 1 superior mesenteric (SMA) and 1 popliteal artery were embolised. Successful occlusion with the AVP was achieved in 21 out of 24 vessels (87.5%), of which 18 (75%) occluded immediately and 3 (12.5%) were delayed occlusions. The three patients who are considered to have failed to occlude with the AVP required the use of additional embolic agents. At the end of the 17-month follow-up all 24 target vessels had occluded. Two patients developed persistent buttock claudication, and one had a left hemiparesis. The AVP is useful as an adjunctive device in the management of aneurysms. It has a particular role in embolisation of large-diameter vessels with a short implantation zone. The device is safe and easy to use.

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Use of the Amplatzer Vascular Plug® for treatment of coronary steal

Cited by 9 publications

References 14 publications

Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting

The Unligated Left Internal Mammary Artery Side Branch as the Cause of Angina after Coronary Artery Bypass Grafting

The Amplatzer vascular plug for large vessel occlusion in the endovascular management of aneurysms

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