Device closure of pulmonary arteriovenous malformation using Amplatzer vascular plug II in hereditary hemorrhagic telangiectasia

Rajesh, Gopalan Nair; Sajeer, Kalathingathodika; Nair, Anishkumar; Vellani, Haridasan; Sajeev, C.G.; Krishnan, M.N.

doi:10.1016/j.ihj.2015.05.024

Cited by 10 publications

(6 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Amplatzer plug is a nitinol-based, self-expanding mesh that is advantageous in maneuverability, repositioning, and low risk for migration [ 6 ]. One disadvantage of vascular plugs is cost; however, this is somewhat mitigated due to the requirement of fewer plugs in comparison to coils for a given AVM embolization [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Similar techniques are employed with transcatheter embolization as the treatment of choice for pulmonary AVMs in all adults and symptomatic children with OWR syndrome, as short-and long-term data have proven it to be effective and safe [4]. There are several available embolization device options for this application including coils, vascular plugs, and occlusion balloons [6]. Furthermore, the treatment of pulmonary AVMs reduces migraine headaches, due to the resolution of hypoxemia and decreased passage of vasoactive substances from venous circulation [2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Optimizing the Interventional Approach for Embolization of Pulmonary Arteriovenous Malformations in Patients With Osler-Weber-Rendu Syndrome

McFarland¹,

Harmon²,

Hunsaker³

et al. 2020

Cureus

View full text Add to dashboard Cite

Techniques in vascular and interventional radiology are adapted to the ever-evolving clinical challenges that interventional operators face. In the case of rare diseases, supporting literature that guides an operator's plan for intervention is limited. As a result, published case reports and series can be utilized to direct future intervention and potentially help others tasked with similar clinical scenarios. The proceeding case offers an interventional solution to a clinical manifestation of an otherwise rare disease, Osler-Weber-Rendu (OWR) syndrome. The supporting literature for techniques in embolization of pulmonary arteriovenous malformations (AVMs) in OWR syndrome is limited due to disease rarity. Therefore, the objective of the following case is to offer clinical insights on how to perform this procedure successfully and critique methods previously utilized.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Optimizing the Interventional Approach for Embolization of Pulmonary Arteriovenous Malformations in Patients With Osler-Weber-Rendu Syndrome

McFarland¹,

Harmon²,

Hunsaker³

et al. 2020

Cureus

View full text Add to dashboard Cite

show abstract

“…Indeed, it may be performed at low risk even in very young patients using coils, detachable balloons, or vascular plugs. [ 3 4 5 6 7 8 ] These latter devices have several advantages over the former ones in terms of precision of deliverability and completeness of closure, although they need larger delivery systems that are not suitable in the neonate and small infants. However, with technical advances in the Amplatzer Vascular Occluder device family, there has been a significant improvement in their profile, pliability, and trackability resulting in their deployment through small-size catheters.…”

Section: Discussionmentioning

confidence: 99%

Arterial duct and pulmonary arteriovenous malformations: A shunt masking a shunt

Giordano¹,

Santoro²,

Palladino³

et al. 2018

Ann Pediatr Card

View full text Add to dashboard Cite

A 5-month-old infant, referred to our institution for percutaneous arterial duct (AD) embolization, showed multiple huge pulmonary arteriovenous malformations (PAVMs) associated with a small AD and several tiny systemic-to-pulmonary collaterals. This anatomic arrangement was a possible cause of lack of cyanosis and disproportionately higher hemodynamic relevance of the ductal shunt. The PAVMs became pathophysiologically evident immediately after the closure of AD and systemic to pulmonary artery collaterals and presented clinically with a life-threatening cyanosis. To improve the patient's clinical and hemodynamic condition, the PAVMs were closed in multiple sittings using a large number of Amplatzer Vascular Plugs (St. Jude Medical Inc., St. Paul, MN, USA). The hemodynamic burden of cardiac malformations resulting in left-to-right shunt may be magnified by the presence of PAVMs as a result of low pulmonary vascular resistance which in turn may completely mask the clinical impact of the latter. Transcatheter approach is life-saving in these complex arrangements.

show abstract

“…Once symptomatic, an AVF requires treatment – of which embolization is the favoured technique. This can be achieved by a number of minimally invasive transcatheter methods, including occlusion plug embolization (Rajesh et al 2015) and coil embolization (Sundarakumar et al 2013). High flow in the fistula usually imposes a significant safety challenge during intervention.…”

Section: Introductionmentioning

confidence: 99%

Dual-balloon assisted super-selective embolisation of high flow arterial venous fistula within a transplant kidney

et al. 2018

View full text Add to dashboard Cite

BackgroundIn this case report, we describe a novel application of the technique of ‘dual-balloon assisted’ cannulation and embolisation of a high flow arterial venous fistula (AVF) in transplant kidney, where attempts at standard and previously described embolisation techniques were proving difficult to achieve.Case presentationSeventy year old gentleman with renal transplant presenting with high output cardiac failure and deteriorating renal function. Angiography demonstrated high flow traumatic AV fistula within transplanted kidney, secondary to multiple biopsies. Attempts at guidewire and guiding sheath placement and stability for occlusion plug deployment were failing due to combination of very high back-flow pressures within the AVF and challenging vascular anatomy; with an aneurysmal, tortuous iliac artery as well as intra renal transplanted vessels. A combination of angioplasty and remodeling aortic balloons in the transplant artery and the host external iliac vein respectively, facilitated stabilization of guiding sheath and hence controlled delivery of an occlusion plug from the venous side of the fistula. The fistula was successfully embolised, leading to complete resolution of patient symptoms and improvement of renal function beyond his previous baseline.ConclusionsPercutaneous embolisation is an established technique to treat iatrogenic AVF in transplant kidneys. High flow pressure through an AVF, as demonstrated in this case, can cause difficulty and raise safety issues in accessing and embolising the AVF using previously described techniques. This case report describes an effective and novel application of the technique of using a second balloon in the host common iliac vein to; lower flow pressure, stabilise the guidewires during plug deployment and prevent displacement of wires and/or plug into the common iliac vein.

show abstract

Device closure of pulmonary arteriovenous malformation using Amplatzer vascular plug II in hereditary hemorrhagic telangiectasia

Cited by 10 publications

References 6 publications

Optimizing the Interventional Approach for Embolization of Pulmonary Arteriovenous Malformations in Patients With Osler-Weber-Rendu Syndrome

Optimizing the Interventional Approach for Embolization of Pulmonary Arteriovenous Malformations in Patients With Osler-Weber-Rendu Syndrome

Arterial duct and pulmonary arteriovenous malformations: A shunt masking a shunt

Dual-balloon assisted super-selective embolisation of high flow arterial venous fistula within a transplant kidney

Contact Info

Product

Resources

About