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Updated: Aug 29, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter retrieval of atrial septal defect and patent ductus arteriosus occluder: a guidance for device
Takanari Fujii1, Hisashi Sugiyama2, Hideaki Kanazawa3
1Pediatric Heart Disease and Adult Congenital Heart Disease Center, Showa University Hospital, Tokyo, Japan.
Insights
This study provides guidance for transcatheter device retrieval, detailing effective snare techniques and sheath sizes for atrial septal defect and patent ductus arteriosus closure devices.
Area of Science:
- Cardiovascular Interventions
- Medical Device Engineering
- Interventional Cardiology
Background:
- Device embolization is a significant complication during transcatheter closure of atrial septal defects (ASD) and patent ductus arteriosus (PDA).
- While percutaneous retrieval is often successful, complex cases may necessitate surgical intervention.
- Standardized methods for transcatheter device retrieval remain underdeveloped.
Purpose of the Study:
- To establish evidence-based guidance for transcatheter device retrieval.
- To determine optimal retrieval strategies based on device type and size through comprehensive bench testing.
Main Methods:
- Bench tests were conducted using various transcatheter devices, including Amplatzer Septal Occluder, Figulla Flex II, Amplatzer Duct Occluder-I/II, and Amplatzer Vascular Plug-II.
- Retrieval equipment evaluated included diagnostic catheters, delivery sheaths, cables, Amplatz goose neck snares, OSYPKA CATCHER, and OSYPKA LASSOS.
- The study investigated the necessary retrieval equipment and sheath sizes for successful retrieval of different device types and sizes.
Main Results:
- For PDA devices, snare type and snaring position are critical factors for successful retrieval.
- For ASD devices, simple snare capture or a double-snare technique with an adequately sized sheath is effective.
- The OSYPKA CATCHER requires special attention during device retrieval procedures.
Conclusions:
- The findings offer guidance for selecting appropriate capture devices and retrieval sheaths or catheters.
- This study aims to improve the success rate and safety of transcatheter device retrieval.
- Optimized retrieval strategies can potentially reduce the need for surgical intervention in complicated cases.
Objectives:
The aim of this study is to establish a guidance for device retrieval based on comprehensive bench tests.
Background:
Device embolisation remains a major complication in transcatheter closure of atrial septal defect and patent ductus arteriosus. Although percutaneous retrieval is feasible in the majority of cases, surgical retrieval may be required in complicated circumstances. However, the methods of transcatheter device retrieval have not been completely established.
Methods:
Bench tests of device retrieval were performed to verify the appropriate retrieval method according to device type/size. The devices used for testing were Amplatzer Septal Occluder (Abbott, Chicago, IL, United States of America), Figulla Flex II (Occlutech GmbH, Jena, Germany), Amplatzer Duct Occluder-I (Abbott), Amplatzer Duct Occluder-II (Abbott), and Amplatzer Vascular Plug-II (Abbott). The retrieval equipment constituted diagnostic catheters (multipurpose catheter and right Judkins catheter, 4-Fr or 5-Fr, Gadelius Medical, Tokyo, Japan), delivery sheath and cables for each device, Amplatz goose neck snares (Medtronic, Minneapolis, MN, United States of America), OSYPKA CATCHER (Osypka ag, Rheinfelden-Herten, Germany), and OSYPKA LASSOS (Osypka). We investigated the retrieval equipment and sheath sizes required for a successful retrieval procedure for variously sized devices.
Results:
For patent ductus arteriosus devices, the type of snare and the snaring position are considered important. For atrial septal defect devices, simple snare capture or a double-snare technique with a sufficiently large sheath is effective. Special care should be taken when using the OSYPKA CATCHER for device retrieval.
Conclusions:
The results of this study may assist in the selection of both capture devices and a retrieval sheath or a catheter for complete retrieval.
