Peripheral Embolization of Amplatzer Device to External Iliac Artery: Do Asymptomatic Patients Require Intervention? A Case Report and Literature Review

BACKGROUND Device embolization is a rare complication of percutaneous closure of paravalvular leaks after transcatheter, surgical aortic, or mitral valve replacement. Management typically involves surgical or endovascular intervention. However, the optimal management of asymptomatic patients with a delayed diagnosis of device embolization remains unclear, as evidence for watchful waiting and/or delayed intervention is limited. CASE REPORT We present a case of 73-year-old man who had undergone endovascular closure of a paravalvular leak following transcatheter aortic valve replacement. The patient experienced device failure and recurrence of aortic stenosis symptoms, and during the redo surgical aortic valve replacement, the occluded device was discovered to have embolized to the left external iliac artery. He initially declined immediate intervention and has remained asymptomatic 1 year after diagnosis. CONCLUSIONS This case highlights the need for individualized management strategies of device embolization. While endovascular or surgical intervention remains the standard approach, watchful waiting may be appropriate in selected asymptomatic patients with delayed diagnosis of peripheral device embolization.