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Elmarsafawy H, Matter M, Abo-Haded HM, Rakha S, Hafez MM, Alsawah GA, Abuelkheir MM. Transcatheter closure of patent ductus arteriosus, evaluating the outcome: Single center experience in Mansoura, Egypt. PROGRESS IN PEDIATRIC CARDIOLOGY 2019. [DOI: 10.1016/j.ppedcard.2018.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Transcatheter Closure of Arterial Duct in Infants < 6 kg: Amplatzer Duct Occluder Type I vs Amplatzer Duct Occluder II Additional Sizes. Pediatr Cardiol 2018; 39:627-632. [PMID: 29453685 DOI: 10.1007/s00246-018-1828-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/01/2018] [Indexed: 10/18/2022]
Abstract
Transcatheter closure of arterial duct (AD) remains challenging in low-weight patients and using Amplatzer Duct Occluder devices is still considered off-label in infants < 6 kg. This study aimed to report a large, single-center experience of percutaneous AD closure in infants < 6 kg as well as to compare the most frequently used devices, Amplatzer Duct Occluder type I (ADO I) and Amplatzer Duct Occluder type II Additional Sizes devices (ADO II-AS) (St. Jude Medical Corp, St. Paul, MN, USA). From March 2000 to March 2017, among the 762 patients submitted to percutaneous closure of AD at our Institution, 33 were infants < 6 kg (age 4.8 ± 2.1 months; weight 5.0 ± 0.9 kg). Fourteen patients (45%) underwent ADO I (Group I) and 19 patients ADO II-AS (Group II) device implantation. AD diameter was 2.6 ± 0.8 (range 1.5-4.0) mm resulting in QP/QS of 2.6 ± 0.0.9 (range 1.1-4.5). Successful device deployment was achieved in all patients without procedural morbidity or mortality. Procedural and fluoroscopy times were not significantly different between the groups. However, total X-ray absorbed dose was significantly higher in Group I (121 ± 69 vs 29 ± 16 mGy/cm2, p < 0.01). Immediate, 24 h, and mid-term (46 ± 37 months, median 39) complete occlusion were recorded in 72.7, 90.9, and 97% of patients, respectively without significant difference between the groups. In conclusion, transcatheter closure of AD with Amplatzer Duct Occluder devices is feasible, safe, and effective also in infants less than 6 kg, without significant difference between the most commonly used devices, namely, ADO I and ADO II-AS.
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Mahmoud HT, Santoro G, Gaio G, D'Aiello FA, Capogrosso C, Palladino MT, Russo MG. Single-center experience in percutaneous closure of arterial duct with Amplatzer duct Occluder II additional sizes. Catheter Cardiovasc Interv 2016; 89:1045-1050. [DOI: 10.1002/ccd.26860] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 10/12/2016] [Accepted: 10/16/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Heba Talat Mahmoud
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Giuseppe Santoro
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Gianpiero Gaio
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Fabio Angelo D'Aiello
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Cristina Capogrosso
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Maria Teresa Palladino
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
| | - Maria Giovanna Russo
- Department of Paediatric Cardiology, A.O.R.N. “Ospedali dei Colli”; 2nd University of Naples; Naples Italy
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Behjati-Ardakani M, Behjati-Ardakani MA, Hadadzadeh M, Moshtaghion SH, Sarebanhassanabadi M. Experience with percutaneous closure of ductus arteriosus using the Amplatzer duct occluder in 243 consecutive patients and long-term results-A single centre study. Niger Med J 2014; 55:394-8. [PMID: 25298604 PMCID: PMC4178336 DOI: 10.4103/0300-1652.140379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Percutaneous closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder (ADO) has become increasingly popular in many cardiovascular centres. This study analysed the long-term results of percutaneous closure of PDA with ADO in a single centre. Materials and Methods: Between May 2004 and January 2013, 243 patients with median age of 2.5 years (range = 30 months to 38 years) and median weight of 10 Kg (range 4.5–80.5 Kg) underwent percutaneous closure of PDA using the ADO. The devices were implanted under fluoroscopic guidance. Patients were followed-up for any complications. Results: The mean diameter of narrow part of PDA was 6.4 ± 2.2 mm. The mean diameter of devices was 7.8 ± 2.3 mm. The devices were successfully implanted in 239 (98.3%) cases. At immediate, 1 day, 1, 6, 12 months and late follow-up, the complete occlusion rate was 33% (79 case), 97.1% (236 case), 97.5% (237 case), 98.3% (238 case), 98.3% (238 case) and 98.3% (238 case), respectively. Residual shunt remained in one case at late follow-up. The device embolisation occurred in five patients. The devices were successful retrieved in three patient and second larger devices were inserted. Two other devices were surgically retrieved and PDAs were ligated. Moderate left pulmonary artery stenosis (LPA) in one child and mild LPA stenosis in one infant were detected. Mild aortic obstruction occurred in one infant. Conclusions: Long-term follow-up of patients indicate that percutaneous closure of PDA using ADO is a safe and effective procedure. However, some complications, including device embolisation, left pulmonary stenosis and aortic obstruction may be observed in some cases.
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Affiliation(s)
| | | | - Mehdi Hadadzadeh
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Liddy S, Oslizlok P, Walsh KP. Comparison of the results of transcatheter closure of patent ductus arteriosus with newer amplatzer devices. Catheter Cardiovasc Interv 2013; 82:253-9. [DOI: 10.1002/ccd.24768] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 11/13/2012] [Accepted: 11/25/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Stephen Liddy
- Department of Cardiology; St Vincent's University Hospital; Dublin 4 Ireland
| | - Paul Oslizlok
- Cardiac Department; Our Lady's Hospital for Sick Children; Crumlin Dublin Ireland
| | - Kevin P. Walsh
- Cardiac Department; Our Lady's Hospital for Sick Children; Crumlin Dublin Ireland
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Transcatheter closure of symptomatic arterial duct in infants younger than 1 year old. Pediatr Cardiol 2012; 33:1397-401. [PMID: 22639001 DOI: 10.1007/s00246-012-0356-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Accepted: 04/27/2012] [Indexed: 10/28/2022]
Abstract
Transcatheter closure is currently considered the first-choice therapeutic option in patent arterial duct (AD), although this approach remains challenging in younger patients. To evaluate feasibility, safety, and mid-term efficacy of percutaneous AD closure using different devices in symptomatic infants <12 months old. Among the 483 patients who underwent transcatheter AD closure at our institution from April 2000 to January 2012, 69 were <12 months old. All patients showed cardiac overload at echocardiography, and 72 % of them were on anticongestive therapy. Based on ductal morphology and local anatomy, AD closure was attempted using detachable coils in 24 cases (group A) or the Amplatzer Duct Occluder (AGA Medical, Golden Valley, MN) device in 45 cases (group B). Procedural feasibility was 95.7 % without any difference between groups (95.8 % vs. 95.6 %, p = NS) as were fluoroscopy and procedural times. AD size was 2.5 ± 0.9 mm, and QP/QS ratio was 2.2 ± 1.1, with both being significantly higher in group B [2.1 ± 0.9 vs. 2.6 ± 0.9 mm (p = 0.04) and 1.7 ± 0.8 vs. 2.5 ± 1.2 (p = 0.009), respectively]. Overall complication rate was 1.5 %, without any difference between groups, as was the occlusion rate at hospital discharge (86 %) and over midterm follow-up (55 ± 36 months) (98.5 %). Percutaneous closure of symptomatic AD might be considered effective and safe in very young infants by tailoring the device choice to ductal morphology and local anatomy. In this setting, the controlled-release coil option was shown to be as effective as the ADO device during midterm follow-up.
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Kim KH, Kim JH, Chung HH, Jong ES, Lee BJ, Seo YS, Yim HJ, Yeon JE, Park JJ, Kim JS, Bak YT, Byun KS. Duodenobronchial fistula presenting with persistent pneumonia: report of a case. Gastrointest Endosc 2011; 74:703-7. [PMID: 21679940 DOI: 10.1016/j.gie.2011.03.1259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Accepted: 03/30/2011] [Indexed: 02/08/2023]
Affiliation(s)
- Key Hyeon Kim
- Division of Gastroenterology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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A case of adult patient ductus arteriosus with congestive heart failure and severe mitral regurgitation. Cardiovasc Interv Ther 2011; 26:278-80. [PMID: 24122597 DOI: 10.1007/s12928-011-0069-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 04/20/2011] [Indexed: 12/12/2022]
Abstract
A 46-year-old woman presented herself at the hospital with progressive effort dyspnea and lower limbs edema which she had had for 3 months. She had a history of surgical ligation of patent ductus arteriosus (PDA) at the age of 25-year-old. A transthoracic cardiac ultrasonography showed left ventricular dilatation, severe functional mitral regurgitation, and a recurrent shunt of PDA. Percutaneous coil closure of PDA was performed and 6 months after the procedure, resolution of functional mitral regurgitation and normalization of left atrial and ventricular sizes were achieved.
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Azhar AS, Abd El-Azim AA, Habib HS. Transcatheter closure of patent ductus arteriosus: Evaluating the effect of the learning curve on the outcome. Ann Pediatr Cardiol 2011; 2:36-40. [PMID: 20300267 PMCID: PMC2840760 DOI: 10.4103/0974-2069.52804] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives: Initial experience with transcatheter closure of patent ductus arteriosus (PDA) using detachable coils and Amplatzer duct occluder devices is reported. We evaluated the outcome, complications, and influence of the learning curve, and also assessed the need of surgical backup for such interventional procedures. Methods: From January 2000 to December 2004, 121 patients underwent transcatheter closure of PDA. Aortic angiogram was performed to evaluate the size, position, and shape of the duct for appropriately choosing the occluder device type and size. A second aortic angiogram was performed 10 minutes after device deployment. Echocardiography was repeated at intervals of 24 hours, then at 1, 3, and 6 months after the procedure to assess complications. Stepwise multiple regression analysis was used to assess the role of experience in improving the outcome of the procedure. Results: Of 121 cases, four patients had pulmonary artery embolization of the occluder device which was successfully retrieved in the catheterization laboratory, while two others had embolization that required surgical intervention. Four patients had temporary residual leak, nine had protrusion of the device into the aorta without significant Doppler pressure gradient or hemolysis on follow-up, and five had partial hemodynamically insignificant obstruction to the left pulmonary artery. Statistical analysis showed that the effect of the learning curve and experience was responsible for 93% improvement in the procedural outcome over the five-year study period. Conclusion: Transcatheter occlusion of PDA is safe and effective alternative to surgery. Complications occurred in those with unfavorable duct anatomy and with the use of multiple coils. Surgical backup was important for such interventional procedures. Experience played a major role in the proper choice of device type and size which greatly influenced the outcome of the procedure.
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Affiliation(s)
- Ahmad S Azhar
- Department of Pediatric Cardiology, The International Medical Center, Jeddah, Saudi Arabia
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Feltes TF, Bacha E, Beekman RH, Cheatham JP, Feinstein JA, Gomes AS, Hijazi ZM, Ing FF, de Moor M, Morrow WR, Mullins CE, Taubert KA, Zahn EM. Indications for cardiac catheterization and intervention in pediatric cardiac disease: a scientific statement from the American Heart Association. Circulation 2011; 123:2607-52. [PMID: 21536996 DOI: 10.1161/cir.0b013e31821b1f10] [Citation(s) in RCA: 492] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Kharouf R, Heitschmidt M, Hijazi ZM. Pulmonary perfusion scans following transcatheter patent ductus arteriosus closure using the Amplatzer devices. Catheter Cardiovasc Interv 2011; 77:664-70. [PMID: 21433271 DOI: 10.1002/ccd.22917] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Accepted: 11/22/2010] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Obstruction to flow in the left pulmonary artery (LPA) is a well-known complication after transcatheter device closure of patent ductus arteriosus (PDA). This complication has been studied for different devices using lung perfusion radionuclide scintigraphy (LPRS), but not for Amplatzer devices. This study was performed to evaluate the effect of such devices on lung perfusion using LPRS. METHODS This is a retrospective study that looked at all patients who had PDA closure using different Amplatzer devices at our center between July 1999 and January 2007. All patients underwent LPRS within 24 hr of the procedure. We compared LPRS with other hemodynamic data obtained by cardiac catheterization and echocardiography. Results are presented as mean ± SD or median and ranges. RESULTS A total of 70 patients had PDA closure using an Amplatzer device; median age was 1.8 years (4 months to 75 years) and median weight was 12 kg (5-112 Kg). Nine patients had associated cardiac anomalies. Sixty eight patients had available LPRS. The mean percent of left lung perfusion (LLP) was 42.7% (± 6.7%). Excluding patients with pre-existing LPA stenosis, 17% had abnormally decreased LLP. On hemodynamic measurements, 62 patients had available direct pressure measurements following PDA closure. None had significant increase. No correlation was found with echocardiographic data. CONCLUSION PDA closure with Amplatzer family of devices is associated with a relatively significant risk of decreased perfusion to the left lung, mostly mild abnormalities. Comparison with catheterization and echocardiographic measurements showed lack of correlation with LPRS findings.
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Affiliation(s)
- Rami Kharouf
- Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, Illinois, USA
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Morris ME, Benjamin M, Gardner GP, Nichols WK, Faizer R. The Use of the Amplatzer Plug to Treat Dysphagia Lusoria Caused by an Aberrant Right Subclavian Artery. Ann Vasc Surg 2010; 24:416.e5-8. [DOI: 10.1016/j.avsg.2009.06.027] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 05/26/2009] [Accepted: 06/07/2009] [Indexed: 02/03/2023]
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Brunetti MA, Ringel R, Owada C, Coulson J, Jennings JM, Hoyer MH, Everett AD. Percutaneous closure of patent ductus arteriosus: A multiinstitutional registry comparing multiple devices. Catheter Cardiovasc Interv 2010; 76:696-702. [DOI: 10.1002/ccd.22538] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Wang JK, Wu MH, Lin MT, Chiu SN, Chen CA, Chiu HH. Transcatheter Closure of Moderate-to-Large Patent Ductus Arteriosus in Infants Using Amplatzer Duct Occluder. Circ J 2010; 74:361-4. [DOI: 10.1253/circj.cj-09-0473] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Mei-Hwan Wu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Ming-Tai Lin
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Shuenn-Nan Chiu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Chun-An Chen
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
| | - Hsin-Hui Chiu
- Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University
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Chen Z, Chen L, Wu L. Transcatheter amplatzer occlusion and surgical closure of patent ductus arteriosus: comparison of effectiveness and costs in a low-income country. Pediatr Cardiol 2009; 30:781-5. [PMID: 19365653 DOI: 10.1007/s00246-009-9440-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Revised: 03/03/2009] [Accepted: 03/18/2009] [Indexed: 11/26/2022]
Abstract
The goal of this study was to compare the effectiveness and cost of transcatheter Amplatzer occlusion with those of surgical closure for patent ductus arteriosus (PDA) in a low-income country, China. Although transcatheter Amplatzer occlusion for PDA has been increasingly performed, surgical PDA closure is still a routine procedure at many hospitals in China. Therefore, the selection of treatment modality for patients with PDA who could undergo either treatment option is controversial. The treatment of patients with PDA from February 2005 to February 2007 was analyzed retrospectively. A total of 130 patients underwent surgical closure for PDA, whereas 51 patients underwent Amplatzer occlusion. There were no deaths and no residual left-to-right shunting in either group at last follow-up. In total, 2% of patients with complications requiring management underwent Amplatzer device closure and 6.2% surgical closure. The mean hospital stay was 3.6 +/- 1.5 days for the device group and 8.8 +/- 2.3 days for the surgical group (p < 0.001). The cost with surgical closure was 26% less than that with Amplatzer device closure (13,841.2 +/- 3630.3 vs. 18,708.7 +/- 1816.5 Renminbi [Chinese currency]; p < 0.001). In conclusion, although transcatheter Amplatzer device occlusion is as effective as and less invasive than surgical closure for PDA, surgical closure is less costly. In low-income countries such as China, where health-care resources are limited, PDA closure with the Amplatzer duct occluder device is not cost-effective.
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Affiliation(s)
- Zhaoyang Chen
- Department of Cardiology, Union Hospital, Fujian Medical University, 88 Jiaotong Road, Fuzhou, Fujian 350004, China
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Huang TC, Chien KJ, Hsieh KS, Lin CC, Lee CL. Comparison of 0.052-Inch Coils vs Amplatzer Duct Occluder for Transcatheter Closure of Moderate to Large Patent Ductus Arteriosus. Circ J 2009; 73:356-60. [DOI: 10.1253/circj.cj-08-0461] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ta Cheng Huang
- Department of Paediatric Cardiology, Veterans General Hospital Kaohsiung
- Institute of Biomedical Sciences, National Sun Yat-Sen University
- National Yang-Ming University
| | - Kuang-Jen Chien
- Department of Paediatric Cardiology, Veterans General Hospital Kaohsiung
- Institute of Biomedical Sciences, National Sun Yat-Sen University
| | - Kai-Sheng Hsieh
- Department of Paediatric Cardiology, Veterans General Hospital Kaohsiung
| | - Chu-Chun Lin
- Department of Paediatric Cardiology, Veterans General Hospital Kaohsiung
| | - Cheng-Liang Lee
- Department of Paediatric Cardiology, Veterans General Hospital Kaohsiung
- Institute of Biomedical Sciences, National Sun Yat-Sen University
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Gudausky TM, Hirsch R, Khoury PR, Beekman RH. Comparison of two transcatheter device strategies for occlusion of the patent ductus arteriosus. Catheter Cardiovasc Interv 2008; 72:675-80. [DOI: 10.1002/ccd.21669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Indications for the use of the Amplatzer vascular plug in interventional radiology. Radiol Med 2008; 113:707-18. [DOI: 10.1007/s11547-008-0306-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2006] [Accepted: 12/14/2006] [Indexed: 10/21/2022]
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SIVAKUMAR KOTHANDAM, FRANCIS EDWIN, KRISHNAN PRASAD. Safety and Feasibility of Transcatheter Closure of Large Patent Ductus Arteriosus Measuring ≥4 mm in Patients Weighing ≤6 kg. J Interv Cardiol 2008; 21:196-203. [DOI: 10.1111/j.1540-8183.2008.00348.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Mangini M, Laganà D, Fontana F, Ianniello A, Nicotera P, Petullà M, Carrafiello G, Fugazzola C. Use of Amplatzer Vascular Plug (AVP) in emergency embolisation: preliminary experience and review of literature. Emerg Radiol 2008; 15:153-60. [PMID: 18193463 DOI: 10.1007/s10140-007-0696-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2007] [Accepted: 12/14/2007] [Indexed: 11/30/2022]
Affiliation(s)
- Monica Mangini
- Vascular and Interventional Radiology, Department of Radiology, University of Insubria, Viale Borri, 57-1100 Varese, Italy,
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Santoro G, Gaio G, Carrozza M, Palladino MT, Russo MG, Calabrò R. Large patent ductus arteriosus closure with multiple controlled-release coils. Int J Cardiol 2007; 116:425-6. [PMID: 16887221 DOI: 10.1016/j.ijcard.2006.03.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2006] [Accepted: 03/25/2006] [Indexed: 10/24/2022]
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22
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Wang JK, Wu MH, Hwang JJ, Chiang FT, Lin MT, Lue HC. Transcatheter closure of moderate to large patent ductus arteriosus with the Amplatzer duct occluder. Catheter Cardiovasc Interv 2007; 69:572-8. [PMID: 17323360 DOI: 10.1002/ccd.20701] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To investigate the acute and follow-up results of transcatheter closure of moderate to large patent ductus arteriosus (PDA) with the Amplatzer duct occluder. METHODS Between April 2000 and June 2005, 237 patients underwent attempted transcatheter closure of PDA, of whom Amplatzer duct occluder was used in 68 patients with moderate-to-large-sized PDA (45 females, with ages ranging from 56 days to 75 years, median 3.3 years). Moderate to large PDA is defined as ductus diameter > or =2.5 mm (> or =3 mm in early phase of this study) in infants and young children, or > or =4 mm in adolescents and adults. The size of device selected was generally at least 1-2 mm larger than ductus diameter. RESULTS The ductus diameter ranged from 2.5 to 8.5 mm (4.1 +/- 1.3 mm). Amplatzer duct occluder was successfully deployed in 66 out of 68 patients. The size of device deployed ranged from 4 to 12 mm (6.3 +/- 1.6 mm). The causes of failure in the 2 patients included calcification of ductus resulting, in failure in advancing a sheath to descending aorta in 1 and kinking of a Cook sheath in the other. Distal embolization of the device occurred several hours later in one. After the device was retrieved percutaneously, the patient was sent to surgery. No other significant complications occurred. In the 3-month follow-up, complete occlusion was achieved in all patients. No patient had left pulmonary artery stenosis. CONCLUSIONS Transcatheter closure of moderate-to-large-sized ductus with Amplatzer ductus occluder is effective and safe.
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Affiliation(s)
- Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
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Rossi M, Rebonato A, Greco L, Stefanini G, Citone M, Speranza A, David V. A New Device for Vascular Embolization: Report on Case of Two Pulmonary Arteriovenous Fistulas Embolization Using the Amplatzer Vascular Plug. Cardiovasc Intervent Radiol 2006; 29:902-6. [PMID: 16718423 DOI: 10.1007/s00270-005-0160-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A pulmonary arteriovenous fistula (PAVF) is a rare vascular malformation commonly treated by embolization with coils or balloons to prevent the risk of several serious complications such as cerebral embolism and brain abscess. A 32-year-old female with two PAVFs and neurological ischemic manifestations has been successfully treated by transcatheter embolization of both fistulas using a new device (Amplatzer Vascular Plug). This self-expanding cylindrical nitinol mesh cage with high radial strength allows a chance of relocation until properly positioned. It is preferred to coils or balloons because a large caliber of feeding artery implied high risk of uncontrollable distal embolization. There appear to be no reports in the literature concerning use of this device, which could represent a useful innovative tool in embolotherapies, especially in large vascular areas.
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Affiliation(s)
- Michele Rossi
- Department of Radiology, S. Andrea Hospital-"La Sapienza", University of Rome, via di Grottarossa 1035, 00189 Rome, Italy
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Kipshidze N, Sadzaglishvili K, Panarella M, Rivera EA, Virmani R, Leon MB. Evaluation of a Novel Endoluminal Vascular Occlusion Device in a Porcine Model: Early and Late Follow-up. J Endovasc Ther 2005; 12:486-94. [PMID: 16048381 DOI: 10.1583/05-1543.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To evaluate the efficacy of a new vascular occlusion device (VOD) in a preclinical controlled study versus embolization coils. METHODS The Biomerix VOD was made from a biodurable porous polyurethane matrix in the shape of a cylinder measuring 1.5 cm long by 6.0 mm wide. Thirty-three swine were selected to undergo embolization of a 3 to 5-mm-diameter iliac artery using either a single VOD (27 animals) or sufficient Cook fibered stainless steel coils to achieve angiographic occlusion (6 controls). Test animals were assigned to undergo angiography at 1 week (n=11), 1 month (n=6), 3 months (n=6), or 6 months (n=4). Two control animals were assigned to angiographic follow-up at 1 week, 1 month, and 3 months. Test and control animals were euthanized at each time point to explant occluded vessels for histological analysis. Study endpoints were device utilization, time to occlusion, postdeployment migration, and persistent angiographic occlusion at 7, 30, 90, and 180 days. RESULTS One VOD was deployed in each test animal, whereas a mean 3.3+/-0.8 coils were needed to achieve angiographic occlusion in the 6 controls (p<0.001). The time to occlusion was significantly shorter with the VOD (1.46+/-0.73 versus 5.83+/-1.60 minutes for the coils; p<0.001). There was no evidence of recanalization or filling defects at the site of VOD deployment, while filling defects were seen in 3 of 6 coil-treated controls. The VOD arm showed superior angiographic occlusion versus coils at the 1-week, 1-month, and 3-month angiographic follow-up time points. Histological evaluation showed that the VOD was equivalent to the embolization coils at the 1-week (n=6) and 1-month (n=6) endpoint (100% luminal occlusion). In the 3-month group (n=6), the VOD showed 95% to 100% luminal occlusion versus 90% to 95% in the control animals. In the 6-month group, VOD showed 85% to 95% occlusion. CONCLUSIONS The Biomerix VOD appears highly effective and reliable, resulting in significantly faster and longer lasting occlusion compared with fibered stainless steel embolization coils.
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Affiliation(s)
- Nicholas Kipshidze
- Department of Interventional Cardiac and Vascular Services, Lenox Hill Hospital, New York, New York 10021, USA.
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