Transvenous embolization of patent ductus arteriosus in 16 dogs using the Amplatzer Vascular Plug II device: description of a modified technique and complications

Abstract

Patent ductus arteriosus (PDA) is a deadly congenital disease in dogs if left untreated. Occlusion of the defect is the treatment of choice and can be achieved by surgical ligation or interventional closure. In this retrospective study of 16 dogs, an alternative to the classically used canine device which is placed by an arterial route is described. The Amplatzer Vascular Plug II^® (AVPII) can be deployed by a transvenous approach, using a modified and simplified technique using a single catheter to perform angiography and device delivery. This allows the percutaneous treatment of smaller dogs <3 kg and the concomitant treatment of pulmonic stenosis if present. Successful and complete closure was achieved in all dogs with a mean device/ampulla diameter ratio of 1.28 and a mean device/ostium ratio of 3.6. Embolization into the pulmonary artery was observed in one dog where the device/ampulla diameter ratio was <1.1 and device/ostium ratio was <2.1. In conclusion, our study confirms that PDA transvenous closure using the AVPII appears to be a viable alternative to transarterial closure, allowing the treatment of smaller dogs and a fully percutaneous approach. Care should be taken in patients with very large ducti where undersizing might result in device embolization.