Amplatzer Vascular Plugs Versus Coils for Embolization of Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia

Abstract

The use of Amplatzer plugs for the embolization of PAVMs in patients with hemorrhagic telangiectasia is associated with a significantly lower rate of re-canalization of feeding vessels than coils. Long-term prospective studies are required to confirm these findings.

Regarding “Amplatzer Vascular Plugs Versus Coils for Embolization of Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia”

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We read with great interest the recent article by Tau et al [1]. The authors concluded that the use of Amplatzer plugs for the embolization of pulmonary arteriovenous malformations (PAVMs) in patients with hemorrhagic telangiectasia is associated with a significantly lower rate of recanalization of feeding vessels than coils.

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Lobar occlusion of pulmonary arteriovenous malformations with Amplatzer vascular plug

“…AVP is a woven, self‐expanding nitinol cylinder that is used for the purpose of occluding vascular structures. The FDA approved the AVP I and AVP II for use in 2004 and September 2007, respectively . In Japan, AVP I and AVP II were approved in 2013, and AVP IV was approved in 2014.…”

“…AVP as a single device is highly effective for PAVM occlusion. Usually, the AVP diameter should be at least 20% larger than the diameter of the feeding vessel . At a diameter of 4–16 mm, 3–22 mm, and 4–8 mm for AVP I, II, and IV, respectively, PAVM with large feeding arteries can be rapidly occluded with a low risk of migration.…”

“…At a diameter of 4–16 mm, 3–22 mm, and 4–8 mm for AVP I, II, and IV, respectively, PAVM with large feeding arteries can be rapidly occluded with a low risk of migration. Compared with coils, AVP for embolization of PAVM is associated with a significantly lower rate of re‐canalization of feeding vessels . There have been few reports on lobar embolization for PAVM .…”

“…A variety of transcatheter closure devices have been used to occlude PAVM; these include coils, detachable balloons, and AVP. 4 AVP is a woven, self-expanding nitinol cylinder that is used for the purpose of occluding vascular structures. The FDA approved the AVP I and AVP II for use in 2004 and September 2007, respectively.…”