title: The Amplatzer vascular plug for large vessel occlusion in the endovascular management of aneurysms.
abstract: 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.
authors.affiliation: Department of Radiology, St.George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom.
authors.forename: Lakshmi A
authors.initials: LA
authors.lastname: Ratnam
authors.forename: Richard M
authors.initials: RM
authors.lastname: Walkden
authors.forename: Graham J
authors.initials: GJ
authors.lastname: Munneke
authors.forename: Robert A
authors.initials: RA
authors.lastname: Morgan
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Belli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome