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The Terumo Azur Vascular Plug for Occlusion of the Patent Ductus Arteriosus in Premature Neonates-A First Clinical
Nicholas Fitzgerald1, Alison Howell1, Conal T Morgan1
1Department of Paediatrics, Division of Cardiology, The Labatt Family Heart Centre, The Hospital for Sick Children, Ontario, Canada.
Background:
Transcatheter patent ductus arteriosus (PDA) occlusion outcomes in premature and low birth weight infants have improved with advances in procedural technique and availability of low-profile devices. We describe our clinical experience with the Azur Vascular Plug (Terumo Medical Corporation, NJ, USA) for PDA occlusion.
Aims:
To assess procedural success, safety and short-term outcomes of the Azur Vascular Plug for PDA occlusion in premature and low birth weight infants.
Methods:
Single-center observational study of all preterm and low birth weight infants who underwent a transcatheter PDA occlusion procedure involving the Azur Vascular Plug between June 2024 and October 2025.
Results:
The Azur Plug was used in 13 infants. The median (range) procedural age was 44 days (17-93 days) and weight 1344 g (855-3900 g). Successful implantation with microcatheter deployment occurred in 12/13 infants. In 11 cases, the 8 mm Azure device was deployed. The ratio of the unconstrained device to the minimal PDA diameter ranged from 2:1 to 4:1 and decreased with experience. The minimal ductal length for deployment was 9.0 mm (lateral angiography). Mean (range) follow-up was 5.8 months (1.5-15.7 months). Complete ductal occlusion prior to 6-month follow-up occurred in 11/12 infants. No aortic obstruction, left pulmonary artery obstruction, or tricuspid valve injury was noted in follow-up.
Conclusion:
The Azur Vascular Plug is a safe and effective option for PDA device occlusion in premature and low birth weight infants. The sizing limits in premature ducts are under evolution. The Azur device appears suitable for ducts with a minimal length of 9.0 mm and, conservatively, a diameter up to 5.0 mm.
