Treatment of pulmonary arteriovenous malformations: clinical experience using different embolization strategies

Akira Adachi, Kengo Ohta, Younes Jahangiri, Yusuke Matsui, Masahiro Horikawa, Yindee Geeratikun, Orapin Chansanti, Shinsaku Yata, Shinya Fujii, Jonathan Steinberger, Frederick S. Keller, Khashayar Farsad

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Results: Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.

Original languageEnglish
JournalJapanese Journal of Radiology
DOIs
Publication statusAccepted/In press - Jan 1 2020

Fingerprint

Arteriovenous Malformations
Blood Vessels
Lung
Therapeutics
Equipment and Supplies
Aneurysm
Veins
Angiography
Recurrence

Keywords

  • Embolization
  • Interventional radiology
  • Pulmonary arteriovenous malformation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Treatment of pulmonary arteriovenous malformations : clinical experience using different embolization strategies. / Adachi, Akira; Ohta, Kengo; Jahangiri, Younes; Matsui, Yusuke; Horikawa, Masahiro; Geeratikun, Yindee; Chansanti, Orapin; Yata, Shinsaku; Fujii, Shinya; Steinberger, Jonathan; Keller, Frederick S.; Farsad, Khashayar.

In: Japanese Journal of Radiology, 01.01.2020.

Research output: Contribution to journalArticle

Adachi, A, Ohta, K, Jahangiri, Y, Matsui, Y, Horikawa, M, Geeratikun, Y, Chansanti, O, Yata, S, Fujii, S, Steinberger, J, Keller, FS & Farsad, K 2020, 'Treatment of pulmonary arteriovenous malformations: clinical experience using different embolization strategies', Japanese Journal of Radiology. https://doi.org/10.1007/s11604-019-00916-1
Adachi, Akira ; Ohta, Kengo ; Jahangiri, Younes ; Matsui, Yusuke ; Horikawa, Masahiro ; Geeratikun, Yindee ; Chansanti, Orapin ; Yata, Shinsaku ; Fujii, Shinya ; Steinberger, Jonathan ; Keller, Frederick S. ; Farsad, Khashayar. / Treatment of pulmonary arteriovenous malformations : clinical experience using different embolization strategies. In: Japanese Journal of Radiology. 2020.
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abstract = "Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9{\%}) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70{\%} at follow-up CT. Results: Technical success rate was 100{\%} and treatment success rate evaluated by CT for the various embolization strategies was 100{\%} for AVP I (n = 6), 100{\%} for AVP I + coils (n = 5), 83.3{\%} for AVP II (n = 6), 40.0{\%} for AVP II + coils (n = 5), 87.5{\%} for AVP 4 (n = 8), 50.0{\%} for AVP 4 + coils (n = 8), and 78.0{\%} for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.",
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AU - Adachi, Akira

AU - Ohta, Kengo

AU - Jahangiri, Younes

AU - Matsui, Yusuke

AU - Horikawa, Masahiro

AU - Geeratikun, Yindee

AU - Chansanti, Orapin

AU - Yata, Shinsaku

AU - Fujii, Shinya

AU - Steinberger, Jonathan

AU - Keller, Frederick S.

AU - Farsad, Khashayar

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N2 - Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Results: Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.

AB - Purpose: To evaluate embolization efficacy of pulmonary arteriovenous malformations (PAVM) using Amplatzer vascular plugs (AVP) and coils. Materials and methods: Eighty-eight embolized simple PAVMs in 38 patients were retrospectively analyzed by follow-up CT. Mean age was 50.2 ± 15.6 years and 22 (57.9%) patients were females. Mean follow-up interval was 38.2 ± 28.4 months (median 29.9 months). Embolization devices included AVP I, AVP II, AVP 4, and coils. Technical success was defined as no visualization of an early draining vein at angiography after embolization. Treatment success was defined as complete disappearance or decrease in size of the venous aneurysm ≥ 70% at follow-up CT. Results: Technical success rate was 100% and treatment success rate evaluated by CT for the various embolization strategies was 100% for AVP I (n = 6), 100% for AVP I + coils (n = 5), 83.3% for AVP II (n = 6), 40.0% for AVP II + coils (n = 5), 87.5% for AVP 4 (n = 8), 50.0% for AVP 4 + coils (n = 8), and 78.0% for coils alone (n = 50). No statistically significant difference in embolization efficacy was seen between different devices (P = 0.083). Although not statistically significant, combination use of coils with AVPs demonstrated lower rates of clinical embolization success (P = 0.053). Conclusion: Embolization of PAVMs demonstrated high technical and treatment success rates with available embolic devices. No significant statistical differences were demonstrated between AVPs. However, the need for both coils and AVPs may suggest a more complicated underlying lesion at risk for recurrence.

KW - Embolization

KW - Interventional radiology

KW - Pulmonary arteriovenous malformation

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