Ureteric embolization for lower urinary tract fistulae: Use of two amplatzer vascular plugs and N-butyl cyanoacrylate employing the "sandwich" technique

Wael E.A. Saad*, S. Kalagher, U. C. Turba, S. S. Sabri, A. W. Park, J. Stone, J. F. Angle, A. H. Matsumoto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Purpose: This study describes and evaluated the effectiveness of occluding distal ureters in the clinical setting of urinary vaginal (vesicovaginal or enterovesicovaginal) fistulae utilizing a new technique which combines Amplatzer vascular plugs and N-butyl cyanoacrylate. Materials: This is a retrospective study (January 2007-December 2010) of patients with urinary-vaginal fistulae undergoing distal ureter embolization utilizing an Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique. An 8-12-mm type-I or type-II Amplatzer vascular plug was delivered using the sheath and deployed in the ureter distal to the pelvic brim. Instillation of 0.8-1.5 cc of N-butyl cyanoacrylate into ureter proximal to the Amplatzer plug was performed. This was followed by another set of 8-12-mm type-I or type-II Amplatzer vascular plugs in a technique referred to as the "sandwich technique." Results: Five ureters in three patients were occluded utilizing the above-described technique during the 4-year study period. Mean maximum size Amplatzer used per ureter was 10.8 mm (range, 8-12). One ureter required three Amplatzer plugs and the rest required two. Two patients (3 ureters) were clinically successful with complete resolution of symptoms in 36-48 h. The third patient (2 ureters) was partly successful and required a second Amplatzer- N-butyl cyanoacrylate sandwich technique embolization. The mean clinical follow-up was 11.3 months (range, 1.7-29.2). Conclusions: The Amplatzer- N-butyl cyanoacrylate-Amplatzer sandwich technique for occluding the distal ureter is safe and effective with a quick (probably due to the N-butyl cyanoacrylate) and durable (probably due to the Amplatzer plugs) clinical response.

Original languageEnglish
Pages (from-to)1068-1072
Number of pages5
JournalCardioVascular and Interventional Radiology
Issue number4
StatePublished - Aug 2013
Externally publishedYes


  • Amplatzer plug
  • Embolization
  • Fistula
  • Genitourinary
  • Glue
  • Ureter


Dive into the research topics of 'Ureteric embolization for lower urinary tract fistulae: Use of two amplatzer vascular plugs and N-butyl cyanoacrylate employing the "sandwich" technique'. Together they form a unique fingerprint.

Cite this