Use of the Amplatzer Vascular Plug as a Coil Constrainer During Endovascular Occlusion of a Dialysis Shunt
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Limb ischemia or ischemic steal syndrome is an uncommon complication, occurring in 1% to 10% of patients following construction of arteriovenous dialysis grafts and fistulas [1, 2]. In this Technical Note we describe the percutaneous closure of an 8-mm dialysis graft causing symptoms of ischemic steal syndrome. Our technique involves the use of an Amplatzer Vascular Plug (AGA Medical Corp., Golden Valley, MN) as a coil constainer to avoid unintended distal coil migration during occlusion of a high flow vascular system.
A 30-year-old female with a history of sickle cell disease, systemic lupus erythematosus, and end-stage renal disease presented for dialysis graft occlusion 4 weeks following surgical creation of a left upper arm, loop-type dialysis graft. The patient described symptoms of vascular steal that began immediately following surgery and progressively worsened over the next 4 weeks. Her symptoms included ischemic rest pain involving her left hand and...
KeywordsAbdominal Aortic Aneurysm Introducer Sheath Amplatzer Vascular Plug Arterial Anastomosis Pulmonary Arteriovenous Malformation