Contraction of the Amplatzer Vascular Plug I and II in pulmonary artery and systemic venous collateral vessels is safe and of no hemodynamic or vascular consequence in short- and mid-term follow-up

J Invasive Cardiol. 2012 Apr;24(4):145-50.

Abstract

Background: The Amplatzer Vascular Plug (AVP) I and AVP II have been used successfully to occlude moderate-large venous collateral vessels (VC) and pulmonary arteriovenous malformations (PAVM) in children and adults with congenital heart disease.

Purpose: To report our experience in 4 patients who underwent device occlusion of systemic venous collaterals (3 patients) and device closure of pulmonary arteriovenous malformation (1 patient) that developed contraction of the AVP.

Methods: The records of all patients who underwent device occlusion utilizing both AVP I and AVP II between November 2006 and January 2011 were retrospectively reviewed. All available follow-up chest x-rays were reviewed and compared with angiograms obtained post device occlusion. A device 30%-50% larger than the targeted vessel was utilized to occlude the vessel.

Results: Four patients were identified with a mean age of 21 years (range, 7 years and 2 months-52 years) and mean weight of 60.6 kg (range, 15.3-131.5 kg). Two patients received AVP I and 2 patients received AVP II. One patient who received the 12 mm AVP I showed moderate contraction. The 3 other patients who received AVP I (6 mm) and AVP II (10 mm, 12 mm) all demonstrated device contraction to the original shape of the device. Mean follow-up time of 24 months (range, 12-40 months) has shown no evidence of hemodynamic or vascular compromise.

Conclusions: Short to mid-term follow-up indicate that contraction of AVP I and AVP II is safe with no evidence of hemodynamic or vascular compromise. Continued long-term follow-up is warranted.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arteriovenous Malformations / diagnostic imaging
  • Arteriovenous Malformations / physiopathology
  • Arteriovenous Malformations / therapy*
  • Child
  • Collateral Circulation / physiology*
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / physiopathology
  • Heart Defects, Congenital / therapy
  • Hemodynamics / physiology*
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiology*
  • Pulmonary Veins / diagnostic imaging
  • Pulmonary Veins / physiology*
  • Radiography, Thoracic
  • Retrospective Studies
  • Septal Occluder Device / adverse effects
  • Septal Occluder Device / classification*
  • Time Factors
  • Treatment Outcome