The use of the Amplatzer Vascular Plug in the prevention of endoleaks during abdominal endovascular aneurysm repair: A systematic literature review on current applications

Vascular ◽  
2021 ◽  
pp. 170853812110251
Author(s):  
Umberto M Bracale ◽  
Anna Petrone ◽  
Michele Provenzano ◽  
Nicola Ielapi ◽  
Liborio Ferrante ◽  
...  
Keyword(s):  
Literature Review ◽  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Vascular Occlusion ◽  
Abdominal Aortic Aneurysm Repair ◽  
Amplatzer Vascular Plug ◽  
Cost Comparison ◽  
Vascular Plug ◽  
Occlusion Device ◽  
Aneurysm Repair

Objectives The Amplatzer Vascular Plug (AVP) is a vascular occlusion device designed to provide optimal embolization in several fields of the endovascular surgery. A full literature review was conducted to analyze AVPs in comparison with coils for the prevention of endoleaks during endovascular abdominal aortic aneurysm repair. Methods A systematic review was designed under PRISMA statement guidelines for systematic reviews and meta-analyses. The results were updated with a subsequent electronic search using Medline and Scopus databases up to December 2019. Results Eighteen articles making this comparison were found. In 79.7% of the cases, the target vessel was the internal iliac artery; in 1.6%, the common iliac artery; and in 16.7%, the inferior mesenteric artery. Risk of complications (buttock claudication, groin hematoma, endoleaks, and erectile dysfunction) after AVP was low. A cost comparison revealed that the mean cost for coils was around US$2262, while the average cost for the AVP was US$310. Conclusions The AVP is an effective and safe device for occluding peripheral vessels, proved to have lower complications rates. Compared with coil embolization, the AVP technique is potentially associated with lower procedural costs.

Anchor Balloon Technique

2017 ◽  
Vol 51 (2) ◽  
pp. 87-90
Author(s):  
Kei Shibuya ◽  
Norimasa Koike ◽  
Jun Mohara ◽  
Toru Takahashi ◽  
Yoshito Tsushima
Keyword(s):  
Iliac Artery ◽  
Internal Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Amplatzer Vascular Plug ◽  
Vascular Plug ◽  
Internal Iliac ◽  
Lumen Catheter ◽  
Balloon Technique ◽  
Aneurysm Repair

Occlusion of an internal iliac artery or its branches is sometimes required prior to abdominal endovascular aneurysm repair. The Amplatzer vascular plug (AVP) is a useful device for this purpose, but it requires a large lumen catheter or guiding sheath to place it in the intended artery. We propose an anchor balloon technique for advancing this guiding sheath/catheter through a tortuous or angulated iliac artery for AVP placement.

scholarly journals Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

2014 ◽  
Vol 13 (4) ◽  
pp. 318-324
Author(s):  
Rodrigo Gibin Jaldin ◽  
Marcone Lima Sobreira ◽  
Regina Moura ◽  
Matheus Bertanha ◽  
Jamil Víctor de Oliveira Mariaúba ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysms ◽  
Abdominal Aortic Aneurysm Repair ◽  
Aortic Aneurysms ◽  
Arterial Access ◽  
Abdominal Aortic ◽  
First Choice ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Endovascular aneurysm repair (EVAR) is already considered the first choice treatment for abdominal aortic aneurysms (AAA). Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.

scholarly journals Prevention of Type II Endoleak Using the AMPLATZER Vascular Plug Before Endovascular Aneurysm Repair

2014 ◽  
Vol 47 (1) ◽  
pp. 28-36 ◽  
Author(s):  
M. Burbelko ◽  
M. Kalinowski ◽  
J.T. Heverhagen ◽  
E. Piechowiak ◽  
A. Kiessling ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Amplatzer Vascular Plug ◽  
Type Ii ◽  
Vascular Plug ◽  
Type Ii Endoleak ◽  
Aneurysm Repair

Experience With Unfavorable Iliac Access When Performing Fenestrated/Branched Endovascular Aneurysm Repair

2021 ◽  
pp. 152660282199112
Author(s):  
Adrien Hertault ◽  
Aurélia Bianchini ◽  
Guillaume Daniel ◽  
Teresa Martin-Gonzalez ◽  
Birgit Sweet ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Endovascular Repair ◽  
Clinical Success ◽  
Multiorgan Failure ◽  
Endovascular Aneurysm Repair ◽  
Small Diameter ◽  
Early Postoperative Period ◽  
Single Center Experience ◽  
Aneurysm Repair

Purpose: To review a single-center experience with fenestrated and branched endovascular aneurysm repair (f/bEVAR) in patients with challenging iliac anatomies. Materials and Methods: A retrospective review of the department’s database identified 398 consecutive patients who underwent complex endovascular repair f/bEVAR between January 2010 and June 2018; of these, 67 had challenging accesses. The strategies implemented to overcome access issues were reviewed, using a dedicated scoring system to evaluate the access (integrating diameter, tortuosity, calcification, and previous open or endovascular repair). Results: In this subgroup of patients, the most common graft design was a 4-vessel fenestrated endograft (27, 40.3%). Hostile access was due to small diameter (<7 mm) in 25 patients (37.3%) and/or concentric calcifications in 19 patients (26.9%). Mean iliac diameter was 5.5±2.6 mm on the right side and 6.0±2.5 mm on the left side. Previous open or endovascular aortoiliac repair had been performed in 15 patients (22.4%), and 20 patients (29.9%) had a stent previously implanted in at least 1 iliac artery, resulting in the inability to perform standard fenestrated repair with access from both sides. Five patients (7.5%) had a single patent iliac access. Eight distinctive strategies were identified to overcome these access issues, including the use of preloaded renal catheters in the endograft delivery system, angioplasty, graft modification (branches instead of fenestrations or 4 preloaded fenestrations), a conduit via a retroperitoneal approach, iliac artery recanalization, and/or the multiple puncture technique. Technical success was achieved in 62 cases (92.5%). Four patients had access complications and 1 died in the early postoperative period of multiorgan failure. Median follow-up was 24.6 months (IQR 7.2, 41.3). Clinical success at the end of follow-up was achieved in 57 patients (85.1%). During follow-up, 14 patients died, including 4 from an aorta-related cause. Conclusion: Dedicated strategies can be implemented to overcome hostile iliac access in patients with complex aneurysms when f/bEVAR is required. Typically, these maneuvers are associated with favorable outcomes.

scholarly journals Fate of Aneurysmal Common Iliac Artery Landing Zones Used for Endovascular Aneurysm Repair

2015 ◽  
Vol 22 (5) ◽  
pp. 748-759 ◽  
Author(s):  
Claire L. Griffin ◽  
Salvatore T. Scali ◽  
Robert J. Feezor ◽  
Catherine K. Chang ◽  
Kristina A. Giles ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Common Iliac Artery ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Repair

scholarly journals Hemodialysis Arteriovenous Access Occlusion Using the Amplatzer Vascular Plug in Patients with Intractable Arm Edema

2017 ◽  
Vol 7 (2) ◽  
pp. 63-72
Author(s):  
Michele Di Filippo ◽  
Danilo Barbarisi ◽  
Doriana Ferrara ◽  
Stefania Brancaccio ◽  
Luca del Guercio ◽  
...  
Keyword(s):  
Vascular Occlusion ◽  
Amplatzer Vascular Plug ◽  
Type Ii ◽  
Vascular Plug ◽  
Jude Medical ◽  
The Third ◽  
Hand Ischemia ◽  
Type Iv ◽  
Arteriovenous Access ◽  
Steal Syndrome

Objectives: Vascular occlusion of hemodialysis arteriovenous access (AVA) using an Amplatzer vascular plug (AVP; St. Jude Medical, St. Paul, MN, USA) is an arising and alternative practice in selected patients; however, few reported cases can be found in the literature. Herein, we report on our experience with endovascular treatment of complicated AVA. Materials and Methods: From September 2015 to December 2016, 3 patients at our clinic underwent an occlusion of hemodialysis AVA with 2 different Amplatzer vascular plugs: 2 patients with type II and 1 patient with type IV. Of these, 1 patient was treated for an autologous radiocephalic fistula, the second patient was treated for an autologous brachiocephalic fistula located at the elbow, and the third was, instead, treated for a radiocephalic forearm fistula. The reason for closing the AVA in all patients was due to the presence of dialysis-associated steal syndrome with critical hand ischemia and intractable ipsilateral edema. Results: All AVAs were treated using an AVP. No plug migration, access revascularization, persistent ischemia, nor other complications were observed. Conclusion: This report suggests that the use of AVP for embolization of complicated AVA is a safe and reasonable alternative to open surgery in selected patients.

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