Amplatzer vascular plugs in congenital cardiovascular malformations

Abstract

Background:Amplatzer vascular plugs (AVPs) are devices ideally suited to close medium-to-large vascular communications. There is limited published literature regarding the utility of AVPs in congenital cardiovascular malformations (CCVMs).Aims:To describe the use of AVPs in different CCVMs and to evaluate their safety and efficacy.Materials and Methods:All patients who required an AVP for the closure of CCVM were included in this retrospective review of our catheterization laboratory data. The efficacy and safety of AVPs are reported.Results:A total of 39 AVPs were implanted in 31 patients. Thirteen (33%) were AVP type I and 23 (59%) were AVP type II. AVP type III were implanted in two patients and type IV in one patient. The major indications for their use included closure of pulmonary arteriovenous malformation (AVM) (n = 7), aortopulmonary collaterals (n = 7), closure of a patent Blalock-Taussig shunt (n = 5), systemic AVM (n = 5), coronary AVM (n = 4), patent ductus arteriosus (PDA) (n = 3), pulmonary artery aneurysms (n = 3), and venovenous collaterals (n = 2). Deployment of the AVP was done predominantly via the 5 – 7F Judkin's right coronary guide catheter. Overall 92% of the AVPs could be successfully deployed and resulted in occlusion of the target vessel in all cases, within 10 minutes. No procedure-related or access site complication occurred.Conclusions:AVPs are versatile, easy to use, and effective devices to occlude the vascular communications in a variety of settings. AVP II is especially useful in the closure of tubular structures with a high flow.

Platelet-rich plasma for open meniscal repair in young patients: Any benefit?

“…Several different therapeutic approaches have been proposed, with a variety of reported results. The most notable of these approaches are the following: the use of parameniscal synovial tissue or collagen matrix [27, 32], trephination of the peripheral meniscus rim with suture of the meniscus tear [50], creation of vascular access channels, use of fibrin clot [3, 4, 16, 20, 39] and fibrin glue [38].…”

Clinical Study to Individual Treatment for Major Aortopulmonary Collaterals of Tetralogy of Fallot

“…Many patients have complications such as low cardiac output syndrome, bloody sputum, lung infection, and pleural effusion [2]. Transcatheter occlusion of MAPCA after surgical correction of TOF effectively solves this problem [3]. However, most previous doctors completely principally relied on experience in the treatment of MAPCAs.…”

Occlusion of a large fistula between the right coronary artery and the right ventricular cavity using Amplatzer® Vascular Plug II. Case report and technical description of the procedure

“…5 Although vascular plugs are devices ideally designed to occlude extracardiac vascular communications, their use for closing intracardiac defects, including arteriovenous fistulas and postoperative paravalvular leaks, possibly using diagnostic catheters (such as Amplatzer® Vascular Plug IV, Abbott Medical, Plymouth, Minnesota, USA), even if off-label, has produced encouraging results, with a reduction in periprocedural morbidity and rapid occlusion of embolized structures, due to its nitinol alloy multi-layered architecture and to the fast clinical recovery of patients. 6,7 The same can be said of the use of controlled release detachable microcoils, ideally used for the occlusion of cerebral aneurysms, and which yield excellent results in very tortuous coronary fistulas with multiple obstructions in their course, since the adjuvant use of microguides and microcatheters allows navigation of tortuous vessels and deployment of embolizing elements (microcoils) in a safe and effective manner. 8,9 In this case report, since the anomalous vessel had no significant tortuosity or stenosed segments, microcoils were not opted for.…”