Amplatz

There are several techniques available for mechanical thrombolysis. The most common is probing the thrombus with a microguidewire. This technique appears to be useful in facilitating chemical thrombolysis. Alternatively, a snare (e.g., Amplatz Goose-Neck Microsnare, Microvena, White Bear Lake, MN) can be used for multiple passes through the occlusion to disrupt the thrombus. " A snare can also be used for clot retrieval, mostly in simations in which the clot has a firm consistency or contains solid material. ... 

A variety of Amplatzer devices are applicable for LAA occlusion including the atrial and ventricular septal defect devices, the patent foramen ovale devices, the patent ductus arteriosus devices, and other arteriovenous fistulae devices. A special fabric-free LAA plug is currently under investigation (Rg. 2). 

The characteristic feature of all Amplatzer devices is the nitinol wire mesh. There are two possible methods of implantation. Either the device is placed entirely into the appendage or the distal disc is expanded in the neck and the proximal disc in the left atrium. The risk of residual shunting around the device is increased when it is totally inserted into the LAA with no part protruding into the atrium. The Amplatzer occluder series holds the widest spectrum of device sizes (4 to 40 mm), The device is attached to a delivery cable and can simply be opened or recollapsed into the delivery catheter. Release is by unscrewing the device after first testing stability with simple traction. 

A residual VSD following surgical closure occurs in 10% to 40% of patients depending on its location (43). Selected patients are suitable for a transcatheter approach. Interventional closure of selected muscular VSD has been possible for some years using the Rashkind (44) and subsequent generation devices (Clamshell, CardioSEAL). Currently the Amplatzer muscular,... 

Amplatzer post myocardial infarction ventricular septar defects (VSD) occluder. 

Amplatzer PFO occluder (AGA Medical Corporation, Golden Valley, MN)... 

I. The Amplatzer occluder (Fig. 5) is probably the most widely used device in this indication. This double disc device... 

Snyder CF, Formanek A, Freeh RS, Amplatz K. The role of sodium in promoting ventricular arrhythmia during selective coronary arteriography. Am J Roentgenol Radium Ther Nucl Med 1971 113(3) 567-71. 

Butto F, Hunter DW, Castaneda-Zuniga W, Amplatz K (1986) Coil-in-coil technique for vascular embolization. Radiology 161 554-555... 

Tadavarthy SM, Moller JH, Amplatz K (1975) Polyvinyl alcohol (Ivalon) a new embolic material. AJR Am J Roentgenol 125 609-616... 

Castaneda-Zuniga WR, Sanchez R, Amplatz K (1978) Experimental observations on short and longterm effects of arterial occlusion with Ivalon. Radiology 126 783-785... 

Lund G, Cragg AH, Rysavy JA, Castaneda F, Castaneda-Zuniga WR, Amplatz K (1983) Detachable stainless-steel... 

Tadavarthy SM, Castaneda-Zuniga W, Zollikofer C, Nemer F, Barron J, Amplatz K (1981) Angiodysplasia of the right colon treated by embolization with ivalon (polyvinyl alcohol). Cardiovasc Intervent Radiol 4 39-42... 

The use of percutaneous sclerotherapy as a treatment for varicocele was first described in 1980 [5]. The most commonly used embolization method in the USA, which is the use of metal coils (Fig. 12.2), was described in 1978 [20]. Ever since, additional materials and methods have been reported including modified coils such as the new Amplatz vascular plug, boiling contrast, detachable balloons. 

The use of detachable balloons to occlude the ISV was first described in 1981 [31]. Due to a lack of FDA approval for some of the devices and manufacturer related issues, the balloons have not always been readily available in the USA. From a technical standpoint, balloons were similar to coils in that they needed to be deployed above and below collateral connections. However, since the balloon occluded the vein completely, much like the Amplatz Vascular Plug, only one was necessary at any given site. As with coils, it was common for users of balloons to perform some type of sclerotherapy on the vein segments between balloons to decrease the development of collaterals. Balloons suffered from two major drawbacks that severely limited their more widespread acceptance. The first was cost. The other was that the size of the catheter required to deliver... 

Amplatz vascular occluder, or coils, preferably with a tornado or other complex shape, and always at least two at each point of embolization... 

Hunter DW, King NJ 3rd, Aeppli DM, Yedlicka JW Jr, Castaneda-Zuniga WR, Hulbert JC, Kaye K, Amplatz K (1991) Spermatic vein occlusion with hot contrast material angiographic results. J Vase Interv Radiol 2 507-515... 

Hunter DW, Bildsoe MC, Amplatz K (1989) Aid for safer sclerotherapy of the internal spermatic vein. Radiology 173 282... 

Gamillscheg A, Schuchlenz H, Stein JI, Beitzke A (2003) Interventional occlusion of a large pulmonary arteriovenous malformation with an Amplatzer septal occuder. J Interv Cardiol 16335-339... 

Congenital heart disease (CHD) occurs in approximately 25 000 births per year in the United States. An atrial septal defect (ASD) is a spedfic form of CHD and is the third most common type of defect. Many people suffer from this disorder and in many cases it is only detected when the patient reaches middle age. Effective and efficient methods of repair are therefore needed to minimize the risks associated with traditional methods of ASD repair. In recent years, transcatheter closure methods for secundum type ASD have been developed. Currently the Amplatzer Septal Occluder, the Gore Helex Septal Occluder and the NMT Medical CardioSEAL-STARFiex Septal Occlusion systems have received FDA approval for ASD repair, the first of these only in 2001. This indicates that the use of these devices is still in its infancy. It can therefore be assumed that much more can be done to develop improved and more effective closure devices. It is the purpose of this chapter to describe ASDs and to outline the available technology with regard to transcatheter ASD repair devices. Hie discussion will centre around their construction and functioning, with special reference to their textile component. 

---