Single-center 10-year retrospective analysis of Amplatzer Vascular Plug 4 embolization for pulmonary arteriovenous malformations with feeding arteries of <6 mm.
Diagn Interv Radiol
; 2024 Jun 03.
Article
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| MEDLINE
| ID: mdl-38836465
ABSTRACT
PURPOSE:
To evaluate the efficacy and safety of Amplatzer Vascular Plug 4 (AVP4) embolization in pulmonary arteriovenous malformations (PAVMs) with small- to medium-sized feeding arteries (<6 mm) and to identify factors affecting persistence and the main persistence patterns after embolization.METHODS:
Between June 2013 and February 2023, we retrospectively reviewed 100 patients with 217 treated PAVMs. We included PAVMs with feeding arteries <6 mm, treated with AVP4 embolization, and followed adequately with computed tomography (CT). Technical success was defined as flow cessation observed on angiography. Persistence was defined as less than a 70% reduction of the venous sac on CT. We evaluated adverse events for each embolization session. Patterns of persistence were assessed using follow-up angiography. Univariate and multivariate analyses were performed to evaluate factors affecting persistence based on the 70% CT criteria.RESULTS:
Fifty-one patients (48 women, 3 men; mean age 50.8 years; age range 16-71 years) with 103 PAVMs met the inclusion criteria. The technical success rate was 100%. The persistence rate was 9.7% (10/103), and the overall adverse event rate was 2.9% (3/103) during a mean follow-up of 556 days (range 181-3,542 days). In two cases, the persistence pattern confirmed by follow-up angiography involved reperfusion via adjacent pulmonary artery collaterals. The location of embolization relative to the last normal branch of the pulmonary artery was the only factor substantially affecting persistence.CONCLUSION:
Embolization with AVP4 appears to be safe and effective for small- to medium-sized PAVMs. The location of the embolization relative to the last normal branch of the pulmonary artery was found to be the main determinant of persistence. CLINICALSIGNIFICANCE:
Given the increasing demand for the treatment of small PAVMs, AVP4 embolization could be considered a viable and effective option for managing PAVMs with feeding arteries <6 mm.
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Bases de datos:
MEDLINE
Idioma:
En
Revista:
Diagn Interv Radiol
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
RADIOLOGIA
Año:
2024
Tipo del documento:
Article