Amplatzer Vascular Plug sealing a chest tube tract in the liver.

When Chest Tubes Go Rogue: How a Vascular Plug Can Save the Day

Avery Sinclair in Health & Wellness August 2025 • 4 min read.

"Learn how interventional radiologists are using Amplatzer Vascular Plugs to safely and effectively fix misplaced chest tubes, preventing serious complications."

Chest tubes are essential tools for draining fluid or air from the chest cavity, often used after surgery or to treat lung conditions. However, like any medical procedure, there's a risk of complications. One rare but dangerous issue is the misplacement of a chest tube, where it ends up in an unintended location, such as the liver.

A recent case highlights how interventional radiologists are tackling this problem with a clever solution: the Amplatzer Vascular Plug (AVP). This tiny device, typically used to block blood vessels, can effectively seal off the misplaced chest tube tract, preventing bleeding and other complications. The original research paper detailed the use of AVP, which inspired another team of researchers to share their findings and further validate the safety and efficiency of AVP.

This article delves into this innovative technique, explaining how it works, why it's beneficial, and what patients need to know. We'll break down the medical jargon and provide a clear, easy-to-understand overview of this potentially life-saving procedure.

The Case of the Misplaced Chest Tube: A Real-Life Emergency

Amplatzer Vascular Plug sealing a chest tube tract in the liver.

Imagine a 70-year-old man admitted to the hospital with difficulty breathing. Doctors discover a mass in his right lung and insert a chest tube to drain a pleural effusion (fluid buildup in the chest). But instead of relieving the pressure, the patient experiences a sudden surge of blood, leading to cardiopulmonary resuscitation. What went wrong?

In this real-life scenario, the chest tube had inadvertently pierced the liver and entered the right ventricle of the heart, via the hepatic vein. This is a rare but life-threatening complication that requires immediate intervention. The patient was quickly stabilized, and doctors turned to interventional radiology for a solution.

The Problem: Misplaced chest tube causing significant internal bleeding.
The Solution: Embolization of the chest tube tract using an Amplatzer Vascular Plug (AVP).
The Goal: To seal off the damaged blood vessel and prevent further bleeding.

Interventional radiologists carefully removed the chest tube, guiding it back to the inferior vena cava (IVC) using fluoroscopy (real-time X-ray imaging). They then inserted a catheter, a thin, flexible tube, through the chest tube tract into the hepatic vein. Finally, they deployed a 6-mm AVP to block the tract. The AVP was strategically placed near a calcification in the liver, helping to ensure accurate placement and prevent migration. Once the AVP was in position, the chest tube and catheter were removed, and the patient made a full recovery and started cancer treatment.

AVP: A Safe and Effective Solution for Misplaced Chest Tubes

This case, along with others in medical literature, suggests that the AVP is a safe and effective tool for managing misplaced chest tubes. It offers a minimally invasive alternative to open surgery, reducing patient risk and recovery time. While careful placement is crucial, the AVP can be easily repositioned if needed, making it a versatile option for interventional radiologists. However, it's important to note that patients with hepatic congestion (liver swelling) may require a different approach, such as a balloon catheter, to control bleeding effectively.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

What is the Amplatzer Vascular Plug (AVP) and how is it used to fix misplaced chest tubes?

The Amplatzer Vascular Plug (AVP) is a small medical device used to block blood vessels. In the context of misplaced chest tubes, it is used by interventional radiologists to seal off the tract created by the misplaced tube. This prevents further bleeding and other complications that can arise when a chest tube ends up in an unintended location, such as the liver or the heart. The AVP is a minimally invasive solution, offering an alternative to open surgery.

What are the potential complications of a misplaced chest tube, and how does the AVP help mitigate these risks?

A misplaced chest tube can lead to serious, life-threatening complications. One significant risk is internal bleeding, as the tube can pierce organs like the liver or vessels like the hepatic vein. This can result in a sudden surge of blood, as illustrated by the case of the 70-year-old man. The AVP addresses these risks by sealing the pathway created by the misplaced chest tube. This stops the bleeding and prevents further damage, significantly improving patient outcomes.

How is the Amplatzer Vascular Plug (AVP) procedure performed to correct a misplaced chest tube?

The procedure involves several precise steps performed by interventional radiologists. First, the misplaced chest tube is carefully removed. Using fluoroscopy (real-time X-ray imaging), the chest tube is guided back to the inferior vena cava (IVC). A catheter, a thin, flexible tube, is then inserted through the chest tube tract into the affected blood vessel, such as the hepatic vein. The AVP is deployed through the catheter to block the tract, effectively sealing it. Finally, the catheter and the chest tube are removed. In the real-life case, the AVP was placed near a calcification in the liver to ensure accurate placement.

Are there any limitations or alternative solutions to using the Amplatzer Vascular Plug (AVP) for misplaced chest tubes?

While the AVP is a safe and effective solution in many cases, it does have limitations. For example, patients with hepatic congestion (liver swelling) might not be ideal candidates for this approach. In such situations, alternative methods, such as a balloon catheter, may be used to control bleeding more effectively. The choice of treatment depends on the specific clinical situation and the patient's overall condition.

What is the significance of the real-life case involving the 70-year-old man, and what does it highlight about the use of the Amplatzer Vascular Plug (AVP)?

The case of the 70-year-old man serves as a powerful example of the life-saving potential of the AVP. The man's chest tube had pierced the liver and entered the right ventricle of the heart, causing significant internal bleeding. The immediate intervention with the AVP, which sealed the bleeding vessel, allowed the patient to be stabilized and eventually recover. This case highlights that the AVP can be a critical tool for interventional radiologists in managing rare, but dangerous, complications from misplaced chest tubes, offering a minimally invasive solution that can drastically improve patient outcomes.