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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 8/2019

01-08-2019 | Interventional Radiology | Clinical Investigation

Long-Term Single-Center Retrospective Follow-Up After Embolization of Pulmonary Arteriovenous Malformations Treated Over a 20-year Period: Frequency of Re-canalization with Various Embolization Materials and Clinical Outcome

Authors: Poul Erik Andersen, Stevo Duvnjak, Oke Gerke, Anette Drøhse Kjeldsen

Published in: CardioVascular and Interventional Radiology | Issue 8/2019

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Abstract

Purpose

The present study is a register-based observational study of an unselected consecutive patient cohort with pulmonary arteriovenous malformations (PAVMs) from a single national hereditary hemorrhagic telangiectasia and PAVM embolization center. The aim was to investigate the frequency of re-embolizations and the clinical outcome after embolization with the use of different embolization materials further, to define which PAVM morphology and size of feeding arteries that most often were re-embolized, and to estimate the clinical outcome of the patients including those that were re-embolized.

Methods

The population was included from 1996 until 2016 and was made up of a total of 136 patients with 322 PAVMs. Median follow-up was 38.3 (0.3–241 months).

Results

The re-embolization rate was 9.3%. None of the PAVMs treated with detachable silicone balloons were re-embolized, while 4.5% treated with vascular plugs and 11.7% treated with coils were re-embolized (p=0.07). In total, 16/74 complex PAVMs were re-embolized compared with 14/248 simple PAVMs. In big-sized feeding arteries ≥ 6mm, 16/112 were re-embolized compared with 14/210 with smaller-sized feeding arteries. Out of the 30 re-embolized PAVMs, 23 resulted in a successful clinical outcome.

Conclusions

Our results suggest that standard coils probably should not be the first choice for embolization of PAVMs, and vascular plug alone or in combination with coils might be a better primary option for embolization in these patients.

Level of Evidence

Level 3A, non-randomized case controlled cohort/follow-up study.
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Metadata
Title
Long-Term Single-Center Retrospective Follow-Up After Embolization of Pulmonary Arteriovenous Malformations Treated Over a 20-year Period: Frequency of Re-canalization with Various Embolization Materials and Clinical Outcome
Authors
Poul Erik Andersen
Stevo Duvnjak
Oke Gerke
Anette Drøhse Kjeldsen
Publication date
01-08-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 8/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02204-x

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