Reperfusion Rates of Pulmonary Arteriovenous Malformations after Coil Embolization: Evaluation with Time-Resolved MR Angiography or Pulmonary Angiography

Shimohira, Masashi; Kawai, Tatsuya; Hashizume, Takumi; Nakagawa, Motoo; Ozawa, Yuichi; Sakurai, Keita; Shibamoto, Yuta

doi:10.1016/j.jvir.2015.02.016

Cited by 47 publications

(32 citation statements)

References 30 publications

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“…Recently, a relatively high recanalization rate has been reported by using contrast enhanced CT [8] or time-resolved MR angiography [13]. When the blood flow of PAVMs remains after embolization, the risk of serious complications persists [5, 9].…”

Section: Discussionmentioning

confidence: 99%

“…The second embolization for recurrent PAVM is more difficult to treat compared to the initial embolization. Shimohira et al [13] demonstrated 100% recurrence rate after the second embolization for recurrent PAVMs. Woodward et al [10] reported pulmonary-to-pulmonary artery reperfusion was more difficult to re-treat successfully than recanalization.…”

Section: Discussionmentioning

confidence: 99%

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Where is the Origin of the Last Normal Branch from Feeding Artery of Pulmonary Arteriovenous Malformations?

Maruno

Kiyosue

Hongo

et al. 2018

Cardiovasc Intervent Radiol

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PurposeReperfusion via pulmonary-to-pulmonary arterial anastomoses is known as one type of recurrence of pulmonary arteriovenous malformations (PAVMs) after embolization. It is important to occlude the fistulous portion beyond the origin of the last normal branch from feeding artery of PAVMs to prevent recurrence. In this study, we evaluate the origin of the last normal branch by CT as well as its visibility on pulmonary arteriography (PAG).Materials and MethodsWe reviewed forty patients with 77 PAVMs who underwent coil embolization between October 2007 and December 2017. All patients underwent MDCT before embolization. Axial and MPR CT lung images were reviewed with special interests in the origin of the last normal branch from feeding artery of PAVMs. The origin was classified into three portions, including sac, junction (portion just proximal to the sac) and proximal feeder (more than 5 mm proximal to the sac). We also evaluated whether PAG can depict the normal branches detected by MDCT.ResultsMDCT showed that the last normal branch originated from sac in 30 PAVMs (39.0%), junction in 39 (50.6%), and proximal feeder in 8 (10.4%).On selective PAG, the last normal branch could be visualized in 30 PAVMs (39.0%), although it could not be visualized due to high-flow shunt in the other 47 PAVMs.ConclusionsSelective PAG frequently fails to demonstrate the last normal branch from feeding artery of PAVMs, which often originates from the sac. Pretherapeutic evaluation of CT images of the last normal branch is important to prevent reperfusion of PAVMs.Level of EvidenceLevel 3, local non-random sample.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Where is the Origin of the Last Normal Branch from Feeding Artery of Pulmonary Arteriovenous Malformations?

Maruno

Kiyosue

Hongo

et al. 2018

Cardiovasc Intervent Radiol

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“…In fact, a previous study showed high diagnostic specificity, sensitivity, PPV and high inter-rater agreement; these values were in striking contrast to those obtained using CT [5]. Furthermore, TR-MRA is a powerful tool for follow-up of treated PAVMs in practical situations [10]. In addition, TR-MRA has another advantage in terms of radiation exposure because the prevalence of PAVM in young people is relatively high [1].…”

Section: Discussionmentioning

confidence: 88%

The Role of Time-Resolved MRA for Post-treatment Assessment of Pulmonary Arteriovenous Malformations: A Pictorial Essay

Kawai

Shimohira

Hashizume

et al. 2016

Cardiovasc Intervent Radiol

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“…They demonstrated that TR-MRA displayed high diagnostic specificity, positive predictive values, and sensitivity, and these values were in marked contrast with those obtained using CT. Moreover, using TR-MRA or DSA, the persistence rates were considerably higher than those reported in the literature evaluated by CT [43]. The sensitivity of TR-MRA appears to be very high, allowing the detection of an even slightly persistent flow.…”

Section: Follow-up and Persistence Of Pavms After Embolizationmentioning

confidence: 60%

Pulmonary Arteriovenous Malformations: Current Technique of Transcatheter Embolization and Subsequent Management

Shimohira

Kawai

Hashizume

et al. 2017

Interventional Radiology

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Pulmonary arteriovenous malformations (PAVMs) cause significant clinical complications, such as transient ischemic attack, stroke, and brain abscess. Nowadays, transcatheter embolization plays an important role in the treatment of PAVM. However, persistence can occur after transcatheter embolization for PAVM. Here, we review the current embolization technique, embolic material, and subsequent management.

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Reperfusion Rates of Pulmonary Arteriovenous Malformations after Coil Embolization: Evaluation with Time-Resolved MR Angiography or Pulmonary Angiography

Cited by 47 publications

References 30 publications

Where is the Origin of the Last Normal Branch from Feeding Artery of Pulmonary Arteriovenous Malformations?

Where is the Origin of the Last Normal Branch from Feeding Artery of Pulmonary Arteriovenous Malformations?

The Role of Time-Resolved MRA for Post-treatment Assessment of Pulmonary Arteriovenous Malformations: A Pictorial Essay

Pulmonary Arteriovenous Malformations: Current Technique of Transcatheter Embolization and Subsequent Management

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