471- 43| Duplex Studies of Amplatzer Vascular Plug II as a Foreign Body: Detection and Localization Following Migration from the Heart to the Extremities-471-43

471-43

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This case report discusses the use of ultrasound in detecting and localizing a foreign body, an Amplatzer Vascular Plug II (AVP II), that migrated into the right arm and left leg. The patient, a 75-year-old male with a history of atrial fibrillation, underwent treatment for a paravalvular leak using two AVP II devices. A subsequent echocardiogram revealed that the devices had migrated. The patient presented with pain and swelling in the left leg, and an AVP II was identified in the left common femoral artery.<br /><br />Ultrasound imaging was used to assess the impact of the AVP II as a foreign body in the arterial systems of the arm and leg. Doppler waveforms were analyzed to compare the hemodynamic effects. In the leg, the AVP II caused a severe stenosis, but the multiphasic Doppler waveform remained unchanged. In the arm, the waveform changed to monophasic below the AVP II. The smaller diameter of the brachial artery compared to the superficial femoral artery may have contributed to this different response.<br /><br />The case illustrates the precision of ultrasound in locating foreign bodies in the arterial system and highlights the unique ability of ultrasound to analyze blood flow through Doppler waveforms. The study suggests that migration of the AVP II may be more prevalent in patients with atrial fibrillation, and further investigation is warranted.<br /><br />Overall, this case report emphasizes the importance of ultrasound in the detection, localization, and hemodynamic analysis of foreign bodies in soft tissues. Ultrasound is a safe and accurate imaging modality without the use of radiation or contrast dye.

Keywords

ultrasound

foreign body

AVP II

migration

Doppler waveforms

stenosis

brachial artery

superficial femoral artery

hemodynamic effects

soft tissues