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Updated: Apr 27, 2026
Closure of a Patent Foramen Ovale PFO: An Intervention Sequence
Published on: December 23, 2022
Amplatzer vascular plug IV for occlusion of pulmonary arteriovenous malformations in a patient with cryptogenic
Surendranath R Veeram Reddy1, Vishal G Patel2, Sarah K Gualano2
1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Abstract:
Paradoxical embolism resulting in cryptogenic stroke has received much attention recently, with the primary focus on patent foramen ovale (PFO). However, it is essential to be vigilant in the search for other causes of paradoxical embolic events, such as pulmonary arteriovenous malformations (PAVM). We describe successful closure of pulmonary AVM with a St Jude Medical (Plymouth, MN) Amplatzer™ vascular plug IV. The newer AVP-IV devices can be used for successful embolization of tortuous pulmonary AVM in remote locations where use of other traditional devices may be technically challenging.
Insights
Pulmonary arteriovenous malformations (PAVM) can cause paradoxical embolism and stroke. Successful closure of PAVM was achieved using the Amplatzer™ vascular plug IV, even in challenging locations.
Area of Science:
- Cardiology
- Interventional Radiology
- Neurology
Background:
- Paradoxical embolism is a recognized cause of cryptogenic stroke.
- Patent foramen ovale (PFO) is the most commonly investigated cause of paradoxical embolism.
- Pulmonary arteriovenous malformations (PAVM) are an under-recognized cause of paradoxical embolism.
Observation:
- A patient presented with a complex, tortuous PAVM.
- Traditional embolic devices posed technical challenges for closure due to the PAVM's anatomy and location.
- The Amplatzer™ vascular plug IV (AVP-IV) device was selected for intervention.
Findings:
- Successful closure of the PAVM was achieved using the Amplatzer™ vascular plug IV.
- The AVP-IV device demonstrated efficacy in embolizing a tortuous PAVM in a challenging location.
- This case highlights the AVP-IV's utility in complex PAVM cases.
Implications:
- The Amplatzer™ vascular plug IV offers a viable and effective treatment for complex PAVMs.
- This expands treatment options for paradoxical embolism originating from PAVMs.
- Increased awareness and utilization of devices like the AVP-IV may improve outcomes for patients with cryptogenic stroke due to PAVM.
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