title: Use of a latest-generation vascular plug for peripheral vascular embolization with use of a diagnostic catheter: preliminary clinical experience.
abstract: OBJECTIVE
  The latest-generation Amplatzer vascular plug (AVP), the AVP 4, is designed for embolization of smaller vessels without a sheath or guiding catheter. This study evaluated the AVP 4 in peripheral vascular embolization.
  
  
  METHODS
  Embolization with the AVP 4 was attempted in 13 patients (11 men) for trauma (n = 7) and other indications (n = 6). Technical success rate, vascular bed, size of catheter, and number and size of AVP 4 devices were recorded.
  
  
  RESULTS
  Embolization with the AVP 4 was successful in 10 of 13 patients (77%). In trauma patients (n = 7), embolization of the splenic artery (n = 4), lumbar artery (n = 2), and superior gluteal artery (n = 1) was performed. In other patients, preoperative embolization of the right portal vein (n = 1), a gastric varix after transjugular intrahepatic portosystemic shunt creation (n = 1), an aneurysm of the internal iliac artery (n = 1), and inferior mesenteric artery (IMA) embolization before aneurysm repair (n = 2) was performed. Sizes of the AVP 4 were 4 mm (n = 6), 6 mm (n = 5), and 8 mm (n = 1). In all patients, 4- and 5-F catheters with a 0.038-inch minimum inner lumen were used. In one patient, IMA embolization was attempted via a femoral approach but was unsuccessful as a result of repeated catheter tip dislocation because of acute angle; coils were used instead.
  
  
  CONCLUSIONS
  Peripheral embolization with the AVP 4 was successful in the majority of patients. Future comparative study is necessary to evaluate this device's benefits over other embolization materials such as earlier-generation AVPs or microcoils.
authors.affiliation: Department of Diagnostic, Interventional and Pediatric Radiology, University Hospital Inselspital Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mordasini
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Szucs-Farkas
authors.forename: Do-Dai
authors.initials: DD
authors.lastname: Do
authors.forename: Jan
authors.initials: J
authors.lastname: Gralla
authors.forename: Joachim
authors.initials: J
authors.lastname: Kettenbach
authors.forename: Hanno
authors.initials: H
authors.lastname: Hoppe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010690:Phlebography; D010865:Pilot Projects; D011300:Preoperative Care; D011474:Prosthesis Design; D013557:Switzerland; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery / Q000628:therapy*