Application of the AMPLATZER vascular plug in endovascular occlusion of dialysis accesses.

The purpose of this study was to share our initial experience with the AMPLATZER Vascular Plug (AVP) in occluding dialysis accesses. Between January 2007 and October 2008, five patients with autogenous and one patient with prosthetic accesses were referred for endovascular occlusion owing to central venous obstruction (n = 4) and dialysis-associated steal syndrome (n = 2) leading to disabling complications. We used a single AVP in two patients, double AVPs in two patients, and double AVPs and n-butyl 2-cyanoacrylate in one patient with an autogenous access. Two coils were deployed between two AVPs to occlude the prosthetic graft. Immediate success was achieved in all patients, with no complications. Mean follow-up time was 13 months (range, 1-21 months) and none of the patients had experienced symptom recurrence as of the time of writing. The AVP allows simple, precise, and reliable dialysis access occlusion without significant complications when surgical ligation is not preferred. It can be used with other embolizing agents to provide occlusion in the case of failure.