Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Other Publications
    • ajnr

User menu

  • Subscribe
  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

  • Subscribe
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Publication Preview--Ahead of Print
    • Past Issue Archive
    • Case of the Week Archive
    • Classic Case Archive
    • Case of the Month Archive
  • For Authors
  • About Us
    • About AJNR
    • Editors
    • American Society of Neuroradiology
  • Submit a Manuscript
  • Podcasts
    • Subscribe on iTunes
    • Subscribe on Stitcher
  • More
    • Subscribers
    • Permissions
    • Advertisers
    • Alerts
    • Feedback
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds
LetterLetter

The Vascular Plug: A New Device for Parent Artery Occlusion

Clemens M. Schirmer, Daniel A. Hoit and Adel M. Malek
American Journal of Neuroradiology September 2007, 28 (8) 1428; DOI: https://doi.org/10.3174/ajnr.A0666
Clemens M. Schirmer
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniel A. Hoit
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Adel M. Malek
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
  • References
  • PDF
Loading

We read with great interest the article by Drs Ross and Buciuc1 in which they reported their experience with using the Amplatzer vascular plug for parent artery occlusion to treat a large aneurysm of the cavernous internal carotid artery. We would like to raise an issue of possible concern, which was a central point of our recent publication on this topic.2 Although we certainly agree with the authors that coil migration and distal coil embolization is a risk of parent vessel occlusion with use of detachable coils, we advocate that the current generation of the Amplatzer vascular plug be used as an adjunct to coil occlusion rather than as a stand-alone device. The Amplatzer plug used in both studies is porous, and is, accordingly, insufficient to seal flow through the vessel in a patient on anticoagulant and antiplatelet therapy.

Contrary to the current report, we saw persistent flow through the device in our patients treated with oral antiplatelet therapy and intravenous anticoagulation, even after waiting for more than 5 minutes and after deploying tandem vascular plugs. We raise this issue because the reduction of blood flow through the interstices of the device with incomplete occlusion can lead to distal embolization of thrombus as it is forming on the plug. Although this possibility may be less of a concern in the peripheral circulation for which the Amplatzer plug was designed, it is of paramount importance in the eloquent cerebral circulation.

Accordingly, our recommendation for the use of the Amplatzer plug was, and remains, as a mechanical anchor to prevent coil migration and ensure interruption of intraprocedural flow. It is hoped that the development of a variant of the Amplatzer plug covered with an impermeable membrane and mounted on a lower-profile delivery wire would make such a device ideally suited for single-step occlusion of even smaller-caliber and more delicate intracranial vessels.

References

  1. ↵
    Ross IB, Buciuc R. The vascular plug: a new device for parent artery occlusion. AJNR Am J Neuroradiol 2007;28:385–86
    Abstract/FREE Full Text
  2. ↵
    Hoit DA, Schirmer CM, Malek AM. Use of the Amplatzer vascular plug as an anchoring scaffold for coil-mediated parent vessel occlusion: technical case report. Neurosurgery 2006;59 (1 Suppl 1):ONSE171–72; discussion ONSE171–72
  • Copyright © American Society of Neuroradiology
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 28 (8)
American Journal of Neuroradiology
Vol. 28, Issue 8
September 2007
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The Vascular Plug: A New Device for Parent Artery Occlusion
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
The Vascular Plug: A New Device for Parent Artery Occlusion
Clemens M. Schirmer, Daniel A. Hoit, Adel M. Malek
American Journal of Neuroradiology Sep 2007, 28 (8) 1428; DOI: 10.3174/ajnr.A0666

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
The Vascular Plug: A New Device for Parent Artery Occlusion
Clemens M. Schirmer, Daniel A. Hoit, Adel M. Malek
American Journal of Neuroradiology Sep 2007, 28 (8) 1428; DOI: 10.3174/ajnr.A0666
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • References
  • Info & Metrics
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Reply:
  • COVID-19-Associated Acute Disseminated Encephalomyelitis–Like Disease
  • Primary Angiitis of the CNS with Unremarkable Vessel Wall MR Imaging: How the “T1 Shinethrough” Effect on SWI Adds to the Detection of Gadolinium Enhancement of Small Intraparenchymal Brain Vessels
Show more Letters

Similar Articles

Advertisement

News and Updates

  • Lucien Levy Best Research Article Award
  • Thanks to our 2020 Distinguished Reviewers
  • Press Releases

Resources

  • Evidence-Based Medicine Level Guide
  • How to Participate in a Tweet Chat
  • AJNR Podcast Archive
  • Ideas for Publicizing Your Research
  • Librarian Resources
  • Terms and Conditions

Opportunities

  • Share Your Art in Perspectives
  • Get Peer Review Credit from Publons
  • Moderate a Tweet Chat

American Society of Neuroradiology

  • Neurographics
  • ASNR Annual Meeting
  • Fellowship Portal
  • Position Statements

© 2021 by the American Society of Neuroradiology | Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire