ISSN: 1899-0967
Polish Journal of Radiology
Established by prof. Zygmunt Grudziński in 1926 Sun
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2018
vol. 83
 
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abstract:
Case report

Transcatheter retrieval of an Amplatzer Vascular Plug

Yozo Sato, Yoshitaka Inaba, Takaaki Hasegawa, Shinichi Murata, Yuki Kimbara, Yoshiki Senda

© Pol J Radiol 2018; 83: e133-e136
Online publish date: 2018/04/08
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Introduction
An Amplatzer Vascular Plug (AVP), which was designed as a permanent occluding device derived from the Amplatzer Septal Occluder and Amplatzer Duct Occluder, is a useful embolic device that can be precisely deployed in medium to large vessels with high resistance to migration. However, migration of these Amplatzer devices has been reported as a relatively rare but major complication.

Case report
A 59-year-old woman was referred for the treatment of advanced pancreatic body cancer; after systemic chemotherapy, distal pancreatectomy with en bloc celiac axis resection (DP-CAR) was planned as curative treatment. Therefore, preoperative embolisation of the common hepatic artery (CHA) for arterial redistribution was performed. Although a 6-mm AVP II was deployed at the mid-portion of the CHA, the AVP migrated to the proper hepatic artery. Although migrated AVP retrieval using a goose neck snare was attempted, it was impossible to retrieve it into the 5-F guiding sheath. Therefore, the AVP was delivered to the splenic artery, which was planned to be resected in DP-CAR. Finally, a 10-mm AVP II was redeployed at the proximal portion of the CHA, and complete occlusion was achieved.

Conclusions
When AVP retrieval is not possible, delivery to the other arteries having lesser influence might be an alternate technique.

keywords:

embolisation, therapeutic/methods, septal occluder device, preoperative care

 
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