Vascular Plugs Improve Pulmonary Arteriovenous Malformation Occlusion over Coil Embolization Alone: A Proof-of-Concept Study Using Dual-Energy CT.
J Vasc Interv Radiol
; 35(10): 1492-1497.e5, 2024 Oct.
Article
em En
| MEDLINE
| ID: mdl-38950821
ABSTRACT
PURPOSE:
To evaluate effectiveness of pulmonary arteriovenous malformation (PAVM) embolization using dual-energy computed tomography (CT) and spectral curve analysis by characterizing contrast enhancement and vascular perfusion as a surrogate of the degree of vascular occlusion after embolotherapy. MATERIALS ANDMETHODS:
Nine consecutive adult patients underwent embolization for 21 PAVMs (size range, 0.4-2.0 cm; 15/21 simple angioarchitecture) and subsequent postembolization chest dual-energy CT angiography. Twelve PAVMs were treated with vascular plugs with or without coils, whereas 9 PAVMs were treated with coils alone. Virtual spectral curves were generated using dual-energy image postprocessing in order to measure embolization effectiveness.RESULTS:
Complete occlusion of target PAVM was achieved in all cases on digital subtraction angiography (DSA) at the end of the embolization procedure. With a median follow-up of 12.7 months, the vascular plug group demonstrated significantly less vascular opacification compared with the coils-only group, as measured by opacification between upstream feeding artery and different downstream vasculature locations (Δslope1 median 79.1 vs 28.6; P = .003; Δslope2 76.4 vs 28.6; P = .0197; Δslope3 78.9 vs 28.6; P = .004). Persistence occurred in 3 PAVMs based on size criteria, which demonstrated higher vascular opacification by dual-energy CT (Δslope1 72 vs 28.6; P = .253; Δslope2 65.1 vs 32.7; P = .326; Δslope3 72.9 vs 53.5; P = .733), although statistical significance was not reached.CONCLUSIONS:
Similar to emerging literature, dual-energy CT showed improved occlusion in PAVMs treated with vascular plugs compared with those treated with coils alone.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Malformações Arteriovenosas
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Artéria Pulmonar
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Veias Pulmonares
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Embolização Terapêutica
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Angiografia por Tomografia Computadorizada
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article