TY - JOUR
T1 - Treatment of pulmonary arteriovenous malformations
T2 - clinical experience using different embolization strategies
AU - Adachi, Akira
AU - Ohta, Kengo
AU - Jahangiri, Younes
AU - Matsui, Yusuke
AU - Horikawa, Masahiro
AU - Geeratikun, Yindee
AU - Chansanti, Orapin
AU - Yata, Shinsaku
AU - Fujii, Shinya
AU - Steinberger, Jonathan
AU - Keller, Frederick S.
AU - Farsad, Khashayar
N1 - Publisher Copyright:
© 2020, Japan Radiological Society.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Results: Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.
AB - Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Results: Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.
KW - Embolization
KW - Interventional radiology
KW - Pulmonary arteriovenous malformation
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U2 - 10.1007/s11604-019-00916-1
DO - 10.1007/s11604-019-00916-1
M3 - Article
C2 - 31912422
AN - SCOPUS:85077558393
SN - 1867-1071
VL - 38
SP - 382
EP - 386
JO - Japanese Journal of Radiology
JF - Japanese Journal of Radiology
IS - 4
ER -