Embolization using hydrogel-coated coils for pulmonary arteriovenous malformations

T. Iguchi, T. Hiraki, Y. Matsui, H. Fujiwara, J. Sakurai, K. Baba, S. Toyooka, H. Gobara, S. Kanazawa

Research output: Contribution to journalArticle

Abstract

Purpose: To prospectively evaluate the efficacy and safety of embolization using hydrogel-coated coils for the treatment of pulmonary arteriovenous malformations (PAVMs). Materials and methods: The outcomes of 21 PAVMs in 19 patients (3 men and 16 women; mean age, 58.8 ± 15.2 [SD] years; age range 14–78 years) treated by venous sac embolization (VSE) with additional feeding artery embolization were prospectively evaluated. For VSE, using one or more 0.018-inch hydrogel-coated coils was mandatory. Recanalization and/or reperfusion were evaluated by pulmonary arteriography 1 year after embolization. Results: The mean feeding artery and venous sac sizes were 4.0 mm and 8.5 mm, respectively. Embolization was successfully completed in 20/21 PAVMs, yielding a technical success rate of 95%. The feeding artery was also embolized in 17/20 successful PAVMs (85%). A technical failure occurred in one PAVM, where embolization was abandoned because of migration of one bare coil to the left ventricle. The mean numbers of hydrogel-coated coils and bare platinum detachable coils used for VSE were 3.3 ± 2.1 (SD) (range, 1–8) and 4.4 ± 3.9 (SD) (range, 1–17), respectively. The mean percentages of hydrogel-coated coils in number, length, and estimated volume were 42.9%, 33.3%, and 72.7% respectively. One patient with one PAVM was lost to follow-up after 3 months. Neither recanalization nor reperfusion was noted in the remaining 19 PAVMs (success rate, 19/19 [100%]). One grade 4 (coil migration) adverse event occurred, and it was treated without any sequelae. Conclusion: VSE using hydrogel-coated coils with additional feeding artery embolization is a safe and effective treatment for PAVM.

Original languageEnglish
JournalDiagnostic and Interventional Imaging
DOIs
Publication statusAccepted/In press - Jan 1 2019

Fingerprint

Hydrogel
Arteriovenous Malformations
Lung
Arteries
Reperfusion
Lost to Follow-Up
Platinum
Heart Ventricles
Angiography
Safety
Therapeutics

Keywords

  • Arteriovenous malformation
  • Embolization
  • Lung
  • Pulmonary arteriovenous fistulas

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

@article{482afaf990af42a5a2eed8969e9070e9,
title = "Embolization using hydrogel-coated coils for pulmonary arteriovenous malformations",
abstract = "Purpose: To prospectively evaluate the efficacy and safety of embolization using hydrogel-coated coils for the treatment of pulmonary arteriovenous malformations (PAVMs). Materials and methods: The outcomes of 21 PAVMs in 19 patients (3 men and 16 women; mean age, 58.8 ± 15.2 [SD] years; age range 14–78 years) treated by venous sac embolization (VSE) with additional feeding artery embolization were prospectively evaluated. For VSE, using one or more 0.018-inch hydrogel-coated coils was mandatory. Recanalization and/or reperfusion were evaluated by pulmonary arteriography 1 year after embolization. Results: The mean feeding artery and venous sac sizes were 4.0 mm and 8.5 mm, respectively. Embolization was successfully completed in 20/21 PAVMs, yielding a technical success rate of 95{\%}. The feeding artery was also embolized in 17/20 successful PAVMs (85{\%}). A technical failure occurred in one PAVM, where embolization was abandoned because of migration of one bare coil to the left ventricle. The mean numbers of hydrogel-coated coils and bare platinum detachable coils used for VSE were 3.3 ± 2.1 (SD) (range, 1–8) and 4.4 ± 3.9 (SD) (range, 1–17), respectively. The mean percentages of hydrogel-coated coils in number, length, and estimated volume were 42.9{\%}, 33.3{\%}, and 72.7{\%} respectively. One patient with one PAVM was lost to follow-up after 3 months. Neither recanalization nor reperfusion was noted in the remaining 19 PAVMs (success rate, 19/19 [100{\%}]). One grade 4 (coil migration) adverse event occurred, and it was treated without any sequelae. Conclusion: VSE using hydrogel-coated coils with additional feeding artery embolization is a safe and effective treatment for PAVM.",
keywords = "Arteriovenous malformation, Embolization, Lung, Pulmonary arteriovenous fistulas",
author = "T. Iguchi and T. Hiraki and Y. Matsui and H. Fujiwara and J. Sakurai and K. Baba and S. Toyooka and H. Gobara and S. Kanazawa",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.diii.2019.10.008",
language = "English",
journal = "Diagnostic and interventional imaging",
issn = "2211-5684",
publisher = "Elsevier Masson",

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TY - JOUR

T1 - Embolization using hydrogel-coated coils for pulmonary arteriovenous malformations

AU - Iguchi, T.

AU - Hiraki, T.

AU - Matsui, Y.

AU - Fujiwara, H.

AU - Sakurai, J.

AU - Baba, K.

AU - Toyooka, S.

AU - Gobara, H.

AU - Kanazawa, S.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: To prospectively evaluate the efficacy and safety of embolization using hydrogel-coated coils for the treatment of pulmonary arteriovenous malformations (PAVMs). Materials and methods: The outcomes of 21 PAVMs in 19 patients (3 men and 16 women; mean age, 58.8 ± 15.2 [SD] years; age range 14–78 years) treated by venous sac embolization (VSE) with additional feeding artery embolization were prospectively evaluated. For VSE, using one or more 0.018-inch hydrogel-coated coils was mandatory. Recanalization and/or reperfusion were evaluated by pulmonary arteriography 1 year after embolization. Results: The mean feeding artery and venous sac sizes were 4.0 mm and 8.5 mm, respectively. Embolization was successfully completed in 20/21 PAVMs, yielding a technical success rate of 95%. The feeding artery was also embolized in 17/20 successful PAVMs (85%). A technical failure occurred in one PAVM, where embolization was abandoned because of migration of one bare coil to the left ventricle. The mean numbers of hydrogel-coated coils and bare platinum detachable coils used for VSE were 3.3 ± 2.1 (SD) (range, 1–8) and 4.4 ± 3.9 (SD) (range, 1–17), respectively. The mean percentages of hydrogel-coated coils in number, length, and estimated volume were 42.9%, 33.3%, and 72.7% respectively. One patient with one PAVM was lost to follow-up after 3 months. Neither recanalization nor reperfusion was noted in the remaining 19 PAVMs (success rate, 19/19 [100%]). One grade 4 (coil migration) adverse event occurred, and it was treated without any sequelae. Conclusion: VSE using hydrogel-coated coils with additional feeding artery embolization is a safe and effective treatment for PAVM.

AB - Purpose: To prospectively evaluate the efficacy and safety of embolization using hydrogel-coated coils for the treatment of pulmonary arteriovenous malformations (PAVMs). Materials and methods: The outcomes of 21 PAVMs in 19 patients (3 men and 16 women; mean age, 58.8 ± 15.2 [SD] years; age range 14–78 years) treated by venous sac embolization (VSE) with additional feeding artery embolization were prospectively evaluated. For VSE, using one or more 0.018-inch hydrogel-coated coils was mandatory. Recanalization and/or reperfusion were evaluated by pulmonary arteriography 1 year after embolization. Results: The mean feeding artery and venous sac sizes were 4.0 mm and 8.5 mm, respectively. Embolization was successfully completed in 20/21 PAVMs, yielding a technical success rate of 95%. The feeding artery was also embolized in 17/20 successful PAVMs (85%). A technical failure occurred in one PAVM, where embolization was abandoned because of migration of one bare coil to the left ventricle. The mean numbers of hydrogel-coated coils and bare platinum detachable coils used for VSE were 3.3 ± 2.1 (SD) (range, 1–8) and 4.4 ± 3.9 (SD) (range, 1–17), respectively. The mean percentages of hydrogel-coated coils in number, length, and estimated volume were 42.9%, 33.3%, and 72.7% respectively. One patient with one PAVM was lost to follow-up after 3 months. Neither recanalization nor reperfusion was noted in the remaining 19 PAVMs (success rate, 19/19 [100%]). One grade 4 (coil migration) adverse event occurred, and it was treated without any sequelae. Conclusion: VSE using hydrogel-coated coils with additional feeding artery embolization is a safe and effective treatment for PAVM.

KW - Arteriovenous malformation

KW - Embolization

KW - Lung

KW - Pulmonary arteriovenous fistulas

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