Pulmonary arteriovenous malformations: results of treatment with coil embolization in 53 patients.

Dutton, Jane A. E.; Jackson, James E.; Hughes, J. M. B.; Whyte, Moira K. B.; Peters, A. M.; Usov, V. Yu.; Allison, David J.

doi:10.2214/ajr.165.5.7572487

Cited by 201 publications

(148 citation statements)

References 2 publications

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“…However, several authors have recommended embolotherapy for lesions with a feeding artery diameter of greater than 3 mm to prevent further complications. 7,16,17) The diameter of the feeding artery in patients with PAVM was larger than 3 mm and ranged between 4 to 10 mm in size.…”

Section: Fig 2 Amentioning

confidence: 99%

Coil Embolization for Pulmonary Arteriovenous Malformation as an Organ-sparing Therapy: Outcome of Long-term Follow-up

Ando

Mochizuki

Kurimoto

et al. 2011

Ann Thorac Cardiovasc Surg

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Purpose: Pulmonary artery coil embolization (PACE) is increasingly utilized to treat pulmonary arteriovenous malformations (PAVMs), but the long-term outcome of this treatment modality remains unclear. By evaluating the long-term outcome of patients at St. Marianna University Hospital treated with PACE, we wanted to see if PACE could effectively replace the surgical resection of PAVMs. Patients and Methods: We retrospectively evaluated 9 consecutive patients (4 males, 5 females; age range, 16-67 years; mean ± SD, 43.6 ± 18.7 years) who underwent PACE for PAVMs. Selective pulmonary artery angiography using Seldinger's method was initially performed to identify the feeding arteries. This was followed by embolization using interlocking detachable coils and microcoils. Results: The procedure resulted in no severe complications. All treated patients were free from PAVM symptoms. A recurrence did not occur after PACE in 8 of 9 (88%) patients for 31 to 173 months (86 ± 51). Recanalization of the embolized malformation occurred after 3 months in one patient. This patient underwent an additional successful PACE without any further recurrences for 73 months. Conclusions: PACE is an organ-sparing therapy with satisfactory long-term results. It can safely replace the surgical resection of PAVMs.

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Section: Fig 2 Amentioning

confidence: 99%

Coil Embolization for Pulmonary Arteriovenous Malformation as an Organ-sparing Therapy: Outcome of Long-term Follow-up

Ando

Mochizuki

Kurimoto

et al. 2011

Ann Thorac Cardiovasc Surg

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“…The reason this question is important is that for individuals with pulmonary AVMs, embolisation is an effective means of reducing lifetime risks of paradoxical embolic stroke and brain abscess [1,2], improving oxygenation [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and treating pulmonary AVM-related haemoptysis [18,19]. Conversely, embolisation may be expected to elevate pulmonary artery pressure (Ppa), since pulmonary AVMs are abnormal dilated vessels between pulmonary arteries and veins that provide low resistance pathways for pulmonary blood flow [20].…”

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confidence: 99%

“…Out of .700 reported pulmonary AVM embolisations [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][34][35][36][37][38][39][40][41][42], data on Ppa measurements pre-and post-embolisation are scarce [9,11,17,32]. In three out of the four reported cases [9,17,32], each selected from larger series, Ppa increased postembolisation, while in the fourth it was unchanged [11].…”

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confidence: 99%

Embolisation of pulmonary arteriovenous malformations: no consistent effect on pulmonary artery pressure

Shovlin¹,

Tighe²,

Davies³

et al. 2008

European Respiratory Journal

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Increasing evidence supports the use of embolisation to treat pulmonary arteriovenous malformations (AVMs). Most pulmonary AVM patients have hereditary haemorrhagic telangiectasia (HHT), a condition that may be associated with pulmonary hypertension.The current authors tested whether pulmonary AVM embolisation increases pulmonary artery pressure (Ppa) in patients without baseline severe pulmonary hypertension. Ppa was measured at the time of pulmonary AVM embolisation in 143 individuals, 131 (92%) of whom had underlying HHT. Angiography/embolisation was not performed in four individuals with severe pulmonary hypertension, whose systemic arterial oxygen saturation exceeded levels usually associated with dyspnoea in pulmonary AVM patients.In 143 patients undergoing pulmonary AVM embolisation, Ppa was significantly correlated with age, with the most significant increase occurring in the upper quartile (aged .58 yrs). In 43 patients with repeated measurements, there was no significant increase in Ppa as a result of embolisation. In half, embolisation led to a fall in Ppa. The maximum rise in mean Ppa was 8 mmHg: balloon test occlusion was performed in one of these individuals, and did not predict the subsequent rise in Ppa following definitive embolisation of the pulmonary AVMs.In the present series of patients, which excluded those with severe pulmonary hypertension, pulmonary artery pressure was not increased significantly by pulmonary arteriovenous malformation embolisation.KEYWORDS: Brain abscess, hypoxaemia, nosebleeds, oxygen saturation, right-to-left shunt, stroke D oes embolisation of pulmonary arteriovenous malformations (AVMs) precipitate pulmonary hypertension (PH)? The reason this question is important is that for individuals with pulmonary AVMs, embolisation is an effective means of reducing lifetime risks of paradoxical embolic stroke and brain abscess [1,2], improving oxygenation [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] and treating pulmonary AVM-related haemoptysis [18,19]. Conversely, embolisation may be expected to elevate pulmonary artery pressure (Ppa), since pulmonary AVMs are abnormal dilated vessels between pulmonary arteries and veins that provide low resistance pathways for pulmonary blood flow [20].The question of whether pulmonary AVM embolisation increases Ppa is particularly pertinent, since most individuals with pulmonary AVMs have underlying hereditary haemorrhagic telangiectasia (HHT). Typically recognised by nosebleeds, mucocutaneous telangiectasia and visceral AVMs [21], HHT may be associated with PH [9,[22][23][24][25][26][27][28][29][30]. The secondary causes of PH in HHT are diverse, as they are in the normal population [31], but PH particularly occurs either as a true pulmonary arterial hypertension (PAH) phenotype [9,22,[28][29][30] or in the context of high output cardiac failure secondary to hepatic AVMs, when PH may be reversible after hepatic AVM treatment [32]. The frequencies of PAH and hepatic AVMs differ with HHT genotype: HHT is caused by mutatio...

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“…Several studies and case reports have been reported in the literature documenting successful treatment of PAVMs using coils and detachable balloons (7,(28)(29)(30)(31). Recently, the AVP became available as a tool in the armamentarium for arterial and venous embolization.…”

Section: Discussionmentioning

confidence: 99%

Persistence of pulmonary arteriovenous malformations after successful embolotherapy with Amplatzer vascular plug: long-term results

Aal¹,

Ibrahim²,

Moustafa³

et al. 2016

Diagn Interv Radiol

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Pulmonary arteriovenous malformations: results of treatment with coil embolization in 53 patients.

Cited by 201 publications

References 2 publications

Coil Embolization for Pulmonary Arteriovenous Malformation as an Organ-sparing Therapy: Outcome of Long-term Follow-up

Coil Embolization for Pulmonary Arteriovenous Malformation as an Organ-sparing Therapy: Outcome of Long-term Follow-up

Embolisation of pulmonary arteriovenous malformations: no consistent effect on pulmonary artery pressure

Persistence of pulmonary arteriovenous malformations after successful embolotherapy with Amplatzer vascular plug: long-term results

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