Initial clinical experience using the Amplatzer Vascular Plug.
OBJECTIVE
The Amplatzer Vascular Plug (AVP) is a self-expanding nitinol wire mesh vascular embolization device derived from the Amplatz septal occluder. We assessed the results of vascular embolization obtained using the AVP.


METHODS
A retrospective review was carried out of 23 consecutive cases of vascular embolization using the AVP in a variety of different clinical settings. The AVP was chosen to have a diameter approximately 30-50% greater than the target vessel. The device was delivered via an appropriately sized guide catheter and was released when satisfactorily positioned. Additional embolic agents were used in some cases.


RESULTS
All target vessels were successfully occluded with no device malpositioning or malfunction. In 14 (61%) patients the AVP was the sole embolic material. In the remaining patients additional agents were used, particularly in preoperative embolization of highly vascular renal tumors. The AVP does not cause instantaneous thrombosis and in high-flow situations thrombosis typically takes up to 15 min.


CONCLUSIONS
The AVP is a safe, effective embolization device that provides a useful adjunct to the therapeutic armamentarium. It is particularly suited to the treatment of short high-flow vessels where coil migration and catheter dislodgment might occur. In the majority of cases no additional embolic agents are necessary but it may take up to 15 min for complete thrombosis to occur.
Tuite
David J
DJ
Department of Vascular and Interventional Radiology, The Leeds Teaching Hospitals NHS Trust, St. James University Hospital, Beckett Street, Leeds, LS9 7TF, UK.
Kessel
David O
DO
Nicholson
Anthony A
AA
Patel
Jai V
JV
McPherson
Simon J
SJ
Shaw
David R
DR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000792:Angiography; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol