Clinical studyEmbolization of Pulmonary Arteriovenous Malformations with Amplatzer Vascular Plugs: Safety and Midterm Effectiveness
Section snippets
Population
This retrospective Health Insurance Portability and Accountability Act–compliant study was conducted in three academic medical centers and approved by all institutional review boards. We included all consecutive patients with AVP embolization of PAVMs from a database of patients who received embolotherapy between December 2005 and September 2009. These were not consecutive PAVMs treated in these centers as other embolic agents were also used at that time, namely coils and detachable balloons.
Results
Twenty-four patients underwent PAVM embolization with the AVP device. Seven (29%) were male and 17 (71%) were female, and patients' ages ranged from 11 to 86 years (mean, 50 y). Nineteen patients (79%) had possible or definite HHT based on clinical criteria. Seven patients (29%) had earlier complications related to PAVM (three had earlier strokes, three had transient ischemic attacks [TIAs], and one had cerebral abscess). Nineteen patients (79%) were assessed in a dedicated HHT clinic.
A total
Discussion
The introduction of AVPs in the PAVM treatment armamentarium has created much debate regarding the best tool to occlude these lesions (2, 17, 18). Currently, the standard treatment of these fistulas is coil embolization, and balloon use has decreased as a result of limited availability.
Not all feeding arteries were amenable to PAVM treatment, mainly because tortuous and angulated feeding arteries could not be safely catheterized to place the AVP close enough to the PAVM. Therefore, AVPs and
References (29)
- et al.
Embolotherapy in the bronchial and pulmonary circulations
Radiol Clin North Am
(2000) - et al.
Bilateral multiple pulmonary arteriovenous malformations: endovascular treatment with the Amplatzer vascular plug
J Vasc Interv Radiol
(2006) - et al.
Occlusion of a pulmonary arteriovenous fistula with an Amplatzer vascular plug
Arch Bronconeumol
(2007) - et al.
Society of Interventional Radiology clinical practice guidelines
J Vasc Interv Radiol
(2003) - et al.
Embolotherapy of pulmonary arteriovenous malformations: efficacy of platinum versus stainless steel coils
J Vasc Interv Radiol
(2004) Re: Bilateral multiple pulmonary arteriovenous malformations: endovascular treatment with the Amplatzer vascular plug
J Vasc Interv Radiol
(2006)- et al.
Re: Bilateral multiple pulmonary arteriovenous malformations: endovascular treatment with the Amplatzer vascular plug
J Vasc Interv Radiol
(2006) - et al.
Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients
J Vasc Interv Radiol
(2004) - et al.
Reperfusion of pulmonary arteriovenous malformations after successful embolotherapy with vascular plugs
J Vasc Interv Radiol
(2008) - et al.
Reperfusion of pulmonary arteriovenous malformations after embolotherapy
J Vasc Interv Radiol
(2005)
Pulmonary arteriovenous malformations: screening procedures and pulmonary angiography in patients with hereditary hemorrhagic telangiectasia
Chest
Interventional embolization of a giant pulmonary arteriovenous malformation with right-left-shunt associated with hereditary hemorrhagic telangiectasia
Clin Res Cardiol
Percutaneous transcatheter embolization of a large pulmonary arteriovenous fistula with an Amplatzer vascular plug
Cardiovasc Intervent Radiol
Transcatheter closure of pulmonary arteriovenous malformations with Amplatzer devices
Cathet Cardiovasc Interv
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G.S. is the recipient of a senior research scholarship from Fonds de la Recherche en Santé du Québec (FRSQ). M.E.F. has received financial support from the Nelson Arthur Hyland Foundation and the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. None of the authors have identified a conflict of interest.