Long-Term Single-Center Retrospective Follow-Up After Embolization of Pulmonary Arteriovenous Malformations Treated Over a 20-year Period: Frequency of Re-canalization with Various Embolization Materials and Clinical Outcome

Journal Article · Thu Aug 15 04:00:00 EDT 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-019-02204-X· OSTI ID:22969209

Duvnjak, Stevo ^[1]; Gerke, Oke; Kjeldsen, Anette Drøhse ^[2]

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1. Odense University Hospital, Department of Radiology (Denmark)
2. University of Southern Denmark, Department of Clinical Research (Denmark)

Purpose: The present study is a register-based observational study of an unselected consecutive patient cohort with pulmonary arteriovenous malformations (PAVMs) from a single national hereditary hemorrhagic telangiectasia and PAVM embolization center. The aim was to investigate the frequency of re-embolizations and the clinical outcome after embolization with the use of different embolization materials further, to define which PAVM morphology and size of feeding arteries that most often were re-embolized, and to estimate the clinical outcome of the patients including those that were re-embolized. Methods: The population was included from 1996 until 2016 and was made up of a total of 136 patients with 322 PAVMs. Median follow-up was 38.3 (0.3–241 months). Results: The re-embolization rate was 9.3%. None of the PAVMs treated with detachable silicone balloons were re-embolized, while 4.5% treated with vascular plugs and 11.7% treated with coils were re-embolized (p=0.07). In total, 16/74 complex PAVMs were re-embolized compared with 14/248 simple PAVMs. In big-sized feeding arteries ≥ 6mm, 16/112 were re-embolized compared with 14/210 with smaller-sized feeding arteries. Out of the 30 re-embolized PAVMs, 23 resulted in a successful clinical outcome. Conclusions: Our results suggest that standard coils probably should not be the first choice for embolization of PAVMs, and vascular plug alone or in combination with coils might be a better primary option for embolization in these patients. Level of Evidence: Level 3A, non-randomized case controlled cohort/follow-up study.

• OSTI ID: 22969209
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 8 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BIOMEDICAL RADIOGRAPHY
FEEDING
MALFORMATIONS
MORPHOLOGY
PATIENTS
SILICONES
VASCULAR DISEASES