Reperfusion of pulmonary arteriovenous malformations after successful embolotherapy with vascular plugs.

Department of Radiology, University of California, San Francisco, 505 Parnassus Ave, Rm M-361, San Francisco, CA 94143, USA. <>
Journal of vascular and interventional radiology: JVIR (Impact Factor: 2.15). 08/2008; 19(8):1246-50. DOI: 10.1016/j.jvir.2008.05.001
Source: PubMed

ABSTRACT Amplatzer vascular plugs (AVPs) are among the embolic agents currently used for occlusion of pulmonary arteriovenous malformations (PAVMs). The authors encountered a patient with multiple PAVMs who developed spontaneous reperfusion of two PAVMs within 7 weeks of initially successful embolization with AVPs. Reperfused PAVMs were effectively occluded by coils deposited proximal to the vascular plugs. AVPs do not provide consistent long-term occlusion of the PAVMs. Deposition of coils proximal to the AVP may decrease the chance of PAVM reperfusion after the embolization.

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    ABSTRACT: The recent generation of AMPLATZER Vascular Plug (AVP; ie, the AVP IV) was used for the occlusion of eight pulmonary arteriovenous malformations (PAVMs) in five patients. A treatment was considered successful when there was a reduction or disappearance of the aneurysmal sac. At a mean follow-up of 20.1 months, no recanalization of PAVMs was observed on multidetector computed tomographic angiography. This shows the AVP IV to be safe and effective as an embolic device to occlude PAVMs.
    Journal of vascular and interventional radiology: JVIR 09/2014; 25(9):1333-1337. DOI:10.1016/j.jvir.2014.05.016 · 2.15 Impact Factor
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    Catheterization and Cardiovascular Interventions 12/2014; 85(6). DOI:10.1002/ccd.25748 · 2.40 Impact Factor
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    ABSTRACT: The purpose of this study is to describe our initial experience with embolization of pulmonary arteriovenous malformations (PAVMs) using hydrogel microcoils. The technical and radiological outcomes were retrospectively reviewed in seven patients with nine simple-type PAVMs (median feeder size 4 mm, range 3-6 mm) who underwent embolization. Hydrogel microcoils were mainly used, and detachable bare microcoils were combined as needed to occlude the terminal feeding artery just before the sac. Of a total of 43 microcoils, 30 (69.8%) hydrogel microcoils were deployed in eight PAVMs with the median number 3.5 (range 2 to 6) per lesion. All hydrogel microcoils were successfully deployed without microcatheter stuck or malposition. In the remaining one small PAVM, only soft bare microcoils were used, however, resulting in recanalization requiring additional coils in the second session. The venous sac was substantially shrunk in all lesions treated with hydrogel microcoils with the median size reduction rate 95.0% (range 81.8% to 99.0%) during the median follow-up period 10 months (range 6 to 18 months). In conclusion, hydrogel microcoils were safely and effectively applied for occluding PAVMs with relatively small feeders.
    SpringerPlus 01/2014; 3:609. DOI:10.1186/2193-1801-3-609