Duplex Studies of Amplatzer Vascular Plug II as a Foreign Body: Detection and Localization Following Migration From the Heart to the Extremities

This case report illustrates the most unique feature of ultrasound that distinguishes it from other imaging modalities: hemodynamic analysis of blood flow by spectral Doppler waveforms. Duplex evaluation of the patient presented showed the different resulting hemodynamic impacts of the Amplatzer Vascular Plug II (AVP II), an embolic device, as a foreign body in the upper extremity versus the lower extremity: monophasic Doppler waveforms in the upper extremity distal to the location of the AVP II versus multiphasic Doppler waveforms in the comparable lower extremity distal location. This hemodynamic analysis illustrates the different impacts of the migrated AVP II as a foreign body. It is possible that paroxysmal atrial fibrillation could have been a cause of AVP II migration in this case, since there was no surgical manipulation following placement, but that would be a topic for further investigation.