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Published in: European Radiology 11/2010

01-11-2010 | Interventional

Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients

Authors: Jonathan L. Hart, Zaid Aldin, Philip Braude, Claire L. Shovlin, James Jackson

Published in: European Radiology | Issue 11/2010

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Abstract

Objective

The technique of embolization of pulmonary arteriovenous malformations (PAVMs) with the Amplatzer vascular plug (AVP) has been reported, but no large series has evaluated the effectiveness of this relatively new embolic device. The purpose of this study is to assess the role of AVPs in the treatment of PAVMs.

Materials and methods

Sixty-nine consecutive patients underwent embolization of pulmonary arteriovenous malformations between September 2006 and December 2008. Clinical, procedural, and physiological data were reviewed retrospectively.

Results

Of 161 PAVMs, 120 (75%) were successfully embolized with Amplatzer vascular plugs alone. Complete and rapid occlusion of feeding vessels was easily achieved at the site of arteriovenous communication without complication. Particularly small or tortuous feeding arteries supplying 27 complex and 14 simple PAVMs were occluded with coils. There have been no documented instances of recanalization on follow-up.

Conclusion

Amplatzer vascular plugs allow the rapid and safe distal occlusion of the majority of PAVMs.
Literature
1.
go back to reference Shovlin CL, Jackson JE (2010) Pulmonary arteriovenous malformations and other pulmonary vascular abnormalities. In: Mason RJ (ed) Murray and Nadel’s textbook of respiratory medicine, 5th edn. Elsevier Saunders, Philadelphia Shovlin CL, Jackson JE (2010) Pulmonary arteriovenous malformations and other pulmonary vascular abnormalities. In: Mason RJ (ed) Murray and Nadel’s textbook of respiratory medicine, 5th edn. Elsevier Saunders, Philadelphia
2.
go back to reference Cottin V, Plauchu H, Bayle JY, Barthelet M, Revel D, Cordier JF (2004) Pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia. Am J Respir Crit Care Med 169:994–1000CrossRefPubMed Cottin V, Plauchu H, Bayle JY, Barthelet M, Revel D, Cordier JF (2004) Pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia. Am J Respir Crit Care Med 169:994–1000CrossRefPubMed
3.
go back to reference Faughnan ME, Granton JT, Young LH (2009) The pulmonary vascular complications of hereditary haemorrhagic telangiectasia. Eur Respir J 33:1186–1194CrossRefPubMed Faughnan ME, Granton JT, Young LH (2009) The pulmonary vascular complications of hereditary haemorrhagic telangiectasia. Eur Respir J 33:1186–1194CrossRefPubMed
4.
go back to reference Sabbà C, Pasculli G, Lenato GM, Suppressa P, Lastella P, Memeo M, Dicuonzo F, Guant G (2007) Hereditary hemorrhagic telangiectasia: clinical features in ENG and ALK1 mutation carriers. J Thromb Haemost 5:1149–1157CrossRefPubMed Sabbà C, Pasculli G, Lenato GM, Suppressa P, Lastella P, Memeo M, Dicuonzo F, Guant G (2007) Hereditary hemorrhagic telangiectasia: clinical features in ENG and ALK1 mutation carriers. J Thromb Haemost 5:1149–1157CrossRefPubMed
5.
go back to reference Shovlin CL, Jackson JE, Bamford KB, Jenkins IH, Benjamin AR, Ramadan H, Kulinskaya E (2008) Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia. Thorax 63:259–662CrossRefPubMed Shovlin CL, Jackson JE, Bamford KB, Jenkins IH, Benjamin AR, Ramadan H, Kulinskaya E (2008) Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia. Thorax 63:259–662CrossRefPubMed
6.
go back to reference Jackson JE, Whyte MK, Allison DJ, Hughes JM (1990) Coil embolization of pulmonary arteriovenous malformations. Cor Vasa 32:191–196PubMed Jackson JE, Whyte MK, Allison DJ, Hughes JM (1990) Coil embolization of pulmonary arteriovenous malformations. Cor Vasa 32:191–196PubMed
7.
go back to reference Dutton JAE, Jackson JE, Hughes JMB, Whyte MK, Peters AM, Ussov W, Allison DJ (1995) Pulmonary arteriovenous malformations: results of treatment with embolization in 53 patients. Am J Roentgenol 165:1119–1125 Dutton JAE, Jackson JE, Hughes JMB, Whyte MK, Peters AM, Ussov W, Allison DJ (1995) Pulmonary arteriovenous malformations: results of treatment with embolization in 53 patients. Am J Roentgenol 165:1119–1125
8.
go back to reference Haitjema TJ, Overtoom TT, Westermann CJ, Lammers JW (1995) Embolisation of pulmonary arteriovenous malformations: results and follow up in 32 patients. Thorax 50:719–723CrossRefPubMed Haitjema TJ, Overtoom TT, Westermann CJ, Lammers JW (1995) Embolisation of pulmonary arteriovenous malformations: results and follow up in 32 patients. Thorax 50:719–723CrossRefPubMed
9.
go back to reference White RI Jr, Pollak JS, Wirth JA (1996) Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy. J Vasc Interv Radiol 7:787–804CrossRefPubMed White RI Jr, Pollak JS, Wirth JA (1996) Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy. J Vasc Interv Radiol 7:787–804CrossRefPubMed
10.
go back to reference Pollak JS, Saluja S, Thabet A, Henderson KJ, White RI (2006) Clinical and anatomical outcomes after embolotherapy of pulmonary arteriovenous malformations. J Vasc Interv Radiol 17:35–45CrossRefPubMed Pollak JS, Saluja S, Thabet A, Henderson KJ, White RI (2006) Clinical and anatomical outcomes after embolotherapy of pulmonary arteriovenous malformations. J Vasc Interv Radiol 17:35–45CrossRefPubMed
11.
go back to reference Milic A, Chan RP, Cohen JH, Faughnan ME (2005) Reperfusion of pulmonary arteriovenous malformations after embolotherapy. J Vasc Interv Radiol 16:1675–1683PubMed Milic A, Chan RP, Cohen JH, Faughnan ME (2005) Reperfusion of pulmonary arteriovenous malformations after embolotherapy. J Vasc Interv Radiol 16:1675–1683PubMed
12.
go back to reference Cil B, Peynircioğlu B, Canyiğit M, Geyik S, Ciftçi T (2008) Peripheral vascular applications of the Amplatzer vascular plug. Diagn Interv Radiol 4:35–39 Cil B, Peynircioğlu B, Canyiğit M, Geyik S, Ciftçi T (2008) Peripheral vascular applications of the Amplatzer vascular plug. Diagn Interv Radiol 4:35–39
13.
go back to reference Rimon U, Heldenberg E, Golan G, Shinfeld A, Garniek A (2008) Amplatzer vascular plug: expanding the applications spectrum. Cardiovasc Interv Radiol 31(Suppl 2):S84–S87CrossRef Rimon U, Heldenberg E, Golan G, Shinfeld A, Garniek A (2008) Amplatzer vascular plug: expanding the applications spectrum. Cardiovasc Interv Radiol 31(Suppl 2):S84–S87CrossRef
14.
go back to reference Conti V, Fiorucci F, Serpilli M, Patrizi A, Paone G, Neri P, Giannunzio G, Pirozzo MG, Fiorucci C, Lucantoni G (2008) Osler-Rendu-Weber syndrome: congenital arteriovenous intrapulmonary fistula treated using a percutaneous Amplatzer plug. Eur Rev Med Pharmacol Sci 12:213–216PubMed Conti V, Fiorucci F, Serpilli M, Patrizi A, Paone G, Neri P, Giannunzio G, Pirozzo MG, Fiorucci C, Lucantoni G (2008) Osler-Rendu-Weber syndrome: congenital arteriovenous intrapulmonary fistula treated using a percutaneous Amplatzer plug. Eur Rev Med Pharmacol Sci 12:213–216PubMed
15.
go back to reference Beck A, Dagan T, Matitiau A, Bruckheimer E (2006) Transcatheter closure of pulmonary arteriovenous malformations with Amplatzer devices. Catheter Cardiovasc Interv 67:932–937CrossRefPubMed Beck A, Dagan T, Matitiau A, Bruckheimer E (2006) Transcatheter closure of pulmonary arteriovenous malformations with Amplatzer devices. Catheter Cardiovasc Interv 67:932–937CrossRefPubMed
16.
go back to reference Tabori NE, Love BA (2008) Transcatheter occlusion of pulmonary arteriovenous malformations using the Amplatzer vascular plug II. Catheter Cardiovasc Interv 71:940–943CrossRefPubMed Tabori NE, Love BA (2008) Transcatheter occlusion of pulmonary arteriovenous malformations using the Amplatzer vascular plug II. Catheter Cardiovasc Interv 71:940–943CrossRefPubMed
17.
go back to reference Ferro C, Rossi UG, Bovio G, Seitun S, Rossi GA (2007) Percutaneous transcatheter embolization of a large pulmonary arteriovenous fistula with an Amplatzer vascular plug. Cardiovasc Intervent Radiol 30:328–331CrossRefPubMed Ferro C, Rossi UG, Bovio G, Seitun S, Rossi GA (2007) Percutaneous transcatheter embolization of a large pulmonary arteriovenous fistula with an Amplatzer vascular plug. Cardiovasc Intervent Radiol 30:328–331CrossRefPubMed
18.
go back to reference Anderson PE, Kieldsen AD (2007) Occlusion of pulmonary arteriovenous malformations by use of vascular plug. Acta Radiol 48:496–499CrossRef Anderson PE, Kieldsen AD (2007) Occlusion of pulmonary arteriovenous malformations by use of vascular plug. Acta Radiol 48:496–499CrossRef
19.
go back to reference Remy J, Remy-Jardin M, Wattinne L, Deffontaines C (1992) Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment. Radiology 182:809–816PubMed Remy J, Remy-Jardin M, Wattinne L, Deffontaines C (1992) Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment. Radiology 182:809–816PubMed
20.
go back to reference Shovlin CL, Guttmacher AE, Buscarini E, Faughnan M, Hyland R, Westermann CJJ, Kjeldsen A, Plauchu H (2000) Diagnostic criteria for hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). Am J Med Genet 91:65–66CrossRef Shovlin CL, Guttmacher AE, Buscarini E, Faughnan M, Hyland R, Westermann CJJ, Kjeldsen A, Plauchu H (2000) Diagnostic criteria for hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome). Am J Med Genet 91:65–66CrossRef
21.
go back to reference Shovlin CL, Tighe HC, Davies RJ, Gibbs JSR, Jackson JE (2008) Embolisation of pulmonary arteriovenous malformations: no consistent effect on pulmonary artery pressure. Eur Respir J 32:162–169CrossRefPubMed Shovlin CL, Tighe HC, Davies RJ, Gibbs JSR, Jackson JE (2008) Embolisation of pulmonary arteriovenous malformations: no consistent effect on pulmonary artery pressure. Eur Respir J 32:162–169CrossRefPubMed
22.
go back to reference White RI, Lynch-Nyhan A, Terry P, Buescher PC, Farmlett EJ, Charnas L, Shuman K, Kim W, Kinnison M, Mitchell SE (1988) Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology 169:663–669PubMed White RI, Lynch-Nyhan A, Terry P, Buescher PC, Farmlett EJ, Charnas L, Shuman K, Kim W, Kinnison M, Mitchell SE (1988) Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology 169:663–669PubMed
23.
go back to reference Remy-Jardin M, Dumont P, Brillet PY, Dupuis P, Duhamel A, Remy J (2006) Pulmonary arteriovenous malformations treated with embolotherapy: helical CT evaluation of long-term effectiveness after 2-21-year follow-up. Radiology 239:576–585CrossRefPubMed Remy-Jardin M, Dumont P, Brillet PY, Dupuis P, Duhamel A, Remy J (2006) Pulmonary arteriovenous malformations treated with embolotherapy: helical CT evaluation of long-term effectiveness after 2-21-year follow-up. Radiology 239:576–585CrossRefPubMed
24.
go back to reference Lee DW, White RI Jr, Egglin TK, Pollak JS, Fayad PB, Wirth JA, Rosenblatt MM, Dickey KW, Burdge CM (1997) Embolotherapy of large pulmonary arteriovenous malformations: long-term results. Ann Thorac Surg 64:930–939CrossRefPubMed Lee DW, White RI Jr, Egglin TK, Pollak JS, Fayad PB, Wirth JA, Rosenblatt MM, Dickey KW, Burdge CM (1997) Embolotherapy of large pulmonary arteriovenous malformations: long-term results. Ann Thorac Surg 64:930–939CrossRefPubMed
25.
go back to reference Mager JJ, Overtoom TT, Blauw H, Lammers JW, Westermann CJ (2004) Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients. J Vasc Interv Radiol 15:451–456PubMed Mager JJ, Overtoom TT, Blauw H, Lammers JW, Westermann CJ (2004) Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients. J Vasc Interv Radiol 15:451–456PubMed
26.
go back to reference Saluja S, Sitko I, Lee DW, Pollak J, White RI (1997) Embolization of pulmonary arteriovenous malformations: long term results. Ann Thorac Surg 64:930–940CrossRef Saluja S, Sitko I, Lee DW, Pollak J, White RI (1997) Embolization of pulmonary arteriovenous malformations: long term results. Ann Thorac Surg 64:930–940CrossRef
27.
go back to reference Brillet PY, Dumont P, Bouaziz N, Duhamel A, Laurent F, Remy J, Remy-Jardin M (2007) Pulmonary arteriovenous malformation treated with embolotherapy: systemic collateral supply at multidetector CT angiography after 2-20-year follow-up. Radiology 242:267–276CrossRefPubMed Brillet PY, Dumont P, Bouaziz N, Duhamel A, Laurent F, Remy J, Remy-Jardin M (2007) Pulmonary arteriovenous malformation treated with embolotherapy: systemic collateral supply at multidetector CT angiography after 2-20-year follow-up. Radiology 242:267–276CrossRefPubMed
28.
go back to reference Lacombe P, Lagrange C, Beauchet A, El Hajjam M, Chinet T, Pelage JP (2009) Diffuse pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: long-term results of embolization according to the extent of lung involvement. Chest 135:1031–1037CrossRefPubMed Lacombe P, Lagrange C, Beauchet A, El Hajjam M, Chinet T, Pelage JP (2009) Diffuse pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: long-term results of embolization according to the extent of lung involvement. Chest 135:1031–1037CrossRefPubMed
29.
go back to reference Aal AKA, Hamed MF, Biosca RF, Saddekni S, Raghuram K (2009) Occlusion time for Amplatzer vascular plug in the management of pulmonary arteriovenous malformations. Am J Roentgenol 192:793–799CrossRef Aal AKA, Hamed MF, Biosca RF, Saddekni S, Raghuram K (2009) Occlusion time for Amplatzer vascular plug in the management of pulmonary arteriovenous malformations. Am J Roentgenol 192:793–799CrossRef
30.
go back to reference Fidelman N, Gordon RL, Bloom AI, LaBerge JM, Kerlan RK Jr (2008) Reperfusion of pulmonary arteriovenous malformations after successful embolotherapy with vascular plugs. J Vasc Interv Radiol 19:1246–1250CrossRefPubMed Fidelman N, Gordon RL, Bloom AI, LaBerge JM, Kerlan RK Jr (2008) Reperfusion of pulmonary arteriovenous malformations after successful embolotherapy with vascular plugs. J Vasc Interv Radiol 19:1246–1250CrossRefPubMed
Metadata
Title
Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients
Authors
Jonathan L. Hart
Zaid Aldin
Philip Braude
Claire L. Shovlin
James Jackson
Publication date
01-11-2010
Publisher
Springer-Verlag
Published in
European Radiology / Issue 11/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-010-1851-2

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