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Title: Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience

Abstract

AIMTo report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT).Materials and MethodsFour consecutive female patients (mean age 38.0 years; range 25–55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization. One patient was symptomatic with recent transient ischaemic attack. Follow-up was undertaken at 1-month post-procedure with CECT to assess PAVMs permeability and MVP positioning and at 1-, 6-, and 12-month post-procedure, with echocardiography/bubble test and standard neurological history, to confirm absence of right-to-left shunts and recurrent symptoms.ResultsEight PAVMs were treated in 4 patients over 5 interventional sessions (mean 1.6 PAVMs per session). All PAVMs were simple, with mean feeding artery diameter of 4.25 mm. Eight 6.5 mm MVPs were deployed in total (one per lesion). Technical success was 100%. Mean procedural time and patient dose per session were 70 min (range 40–70 min) and 53418 mGy.cm{sup 2} (range 6113–101628 mGy.cm{sup 2}), respectively. No signs of reperfusion neither of MPV migration were noted at 1-month CECT follow-up. At early follow-up (mean 3.75 months; range 1–12 months), clinical success was 100% with no evidence of recurrent right-to-left shunt, and no neurological symptoms.more » No immediate or late complications were observed.ConclusionsMVP embolization of PAVMs appears technically feasible, safe, and effective at early follow-up. Further prospective studies are required to confirm long-term safety and efficacy of this promising technique.« less

Authors:
;  [1];  [2];  [1];  [3]; ;  [1]
  1. Hôpitaux Universitaires de Strasbourg, Service de Imagerie Interventionelle, Nouvel Hôpital Civil (France)
  2. Hôpitaux Universitaires de Strasbourg, Service Service de Pneumologie, Nouvel Hôpital Civil (France)
  3. Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom)
Publication Date:
OSTI Identifier:
22645335
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 40; Journal Issue: 2; Other Information: Copyright (c) 2017 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; BUBBLES; BYPASSES; CLOSURES; COMPUTERIZED TOMOGRAPHY; DIAGNOSIS; MALFORMATIONS; PATIENTS; PERMEABILITY; SYMPTOMS; VASCULAR DISEASES

Citation Formats

Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it, Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr, Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr, Garnon, Julien, E-mail: juleiengarnon@gmail.com, Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, and Gangi, Afshin, E-mail: gangi@unistra.fr. Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience. United States: N. p., 2017. Web. doi:10.1007/S00270-016-1493-0.
Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it, Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr, Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr, Garnon, Julien, E-mail: juleiengarnon@gmail.com, Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, & Gangi, Afshin, E-mail: gangi@unistra.fr. Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience. United States. doi:10.1007/S00270-016-1493-0.
Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it, Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr, Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr, Garnon, Julien, E-mail: juleiengarnon@gmail.com, Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com, Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it, and Gangi, Afshin, E-mail: gangi@unistra.fr. Wed . "Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience". United States. doi:10.1007/S00270-016-1493-0.
@article{osti_22645335,
title = {Pulmonary Arteriovenous Malformations Embolized Using a Micro Vascular Plug System: Technical Note on a Preliminary Experience},
author = {Boatta, Emanuele, E-mail: emanuele.boatta@yahoo.it and Jahn, Christine, E-mail: christine.jahn@chru-strasbourg.fr and Canuet, Matthieu, E-mail: matthieu.canuet@chru-strasbourg.fr and Garnon, Julien, E-mail: juleiengarnon@gmail.com and Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com and Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it and Gangi, Afshin, E-mail: gangi@unistra.fr},
abstractNote = {AIMTo report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT).Materials and MethodsFour consecutive female patients (mean age 38.0 years; range 25–55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization. One patient was symptomatic with recent transient ischaemic attack. Follow-up was undertaken at 1-month post-procedure with CECT to assess PAVMs permeability and MVP positioning and at 1-, 6-, and 12-month post-procedure, with echocardiography/bubble test and standard neurological history, to confirm absence of right-to-left shunts and recurrent symptoms.ResultsEight PAVMs were treated in 4 patients over 5 interventional sessions (mean 1.6 PAVMs per session). All PAVMs were simple, with mean feeding artery diameter of 4.25 mm. Eight 6.5 mm MVPs were deployed in total (one per lesion). Technical success was 100%. Mean procedural time and patient dose per session were 70 min (range 40–70 min) and 53418 mGy.cm{sup 2} (range 6113–101628 mGy.cm{sup 2}), respectively. No signs of reperfusion neither of MPV migration were noted at 1-month CECT follow-up. At early follow-up (mean 3.75 months; range 1–12 months), clinical success was 100% with no evidence of recurrent right-to-left shunt, and no neurological symptoms. No immediate or late complications were observed.ConclusionsMVP embolization of PAVMs appears technically feasible, safe, and effective at early follow-up. Further prospective studies are required to confirm long-term safety and efficacy of this promising technique.},
doi = {10.1007/S00270-016-1493-0},
journal = {Cardiovascular and Interventional Radiology},
number = 2,
volume = 40,
place = {United States},
year = {Wed Feb 15 00:00:00 EST 2017},
month = {Wed Feb 15 00:00:00 EST 2017}
}