Large pulmonary arteriovenous malformations: long-term results of embolization with AMPLATZER vascular plugs.

PURPOSE: To analyze the long-term results of endovascular treatment of large pulmonary arteriovenous malformations (PAVMs) using the AMPLATZER vascular plug (AVP; AGA Medical Corp, Golden Valley, Minnesota). MATERIALS AND METHODS: Between May 2007 and April 2011, 18 patients with 24 large PAVMs, defined as PAVMs that had a feeding artery with a diameter of ≥ 8 mm, were treated with AVP I or AVP II. A single AVP device was used for each PAVM. Aneurysmal sac diameters, sac perfusion, sac shrinkage, and complete resolution before and after the intervention were analyzed. Complete histories, laboratory values, physical examinations, and multidetector computed tomography images were reviewed. The mean occlusion time for AVP I and AVP II and the mean arterial oxygen saturation (SaO2) before and after the intervention were compared. RESULTS: The mean diameter of the feeding artery was 11.46 mm ± 2.18 (range, 8-13.3 mm). The mean occlusion time was 7.34 minutes ± 1.23 for AVP I and 6.25 minutes ± 1.12 for AVP II (P = .11). The mean SaO2 before and after the intervention was 63.71% ± 8.10% (range, 51%-76%) and 96.28% ± 0.49% (range, 96%-97%), respectively (P = .045). No major periprocedural complications were observed. The mean follow-up duration was 36.33 months ± 10.63 (range, 28-56 mo). During the follow-up period, there were no persistent sac perfusions, migration of the AVPs, major complications, or recanalizations. CONCLUSIONS: Treatment of large PAVMs with AVPs is an effective method for obtaining excellent long-term results. Embolization of large feeding arteries can be accomplished with AVPs without major complications.

Morphometric study of a horseshoe kidney.

OBJECTIVE: To describe a horseshoe kidney, a congenital anomaly of the upper urinary tract. CLINICAL PRESENTATION: A case study of horseshoe kidney harvested from a 62-year-old cadaver at Gazi University Medical School is presented. RESULTS: The right and left kidneys were fused at their lower poles by a parenchymal isthmus located ventral to the abdominal aorta and formed a U-shape with two unequal arms. The isthmus of the ectopic kidney was placed obliquely to the left at the level of the fourth and fifth lumbar vertebra. The left kidney was larger and longer than the right one. The kidneys were supplied by three renal arteries arising from the abdominal aorta. Two arteries on the right side supplied blood of the two kidneys, while the third artery that directly originated from the aorta, above the origin of inferior mesenteric artery, supplied the isthmus. Venous drainage of the both kidneys and the isthmus were drained by three veins that opened independently into the inferior vena cava. The right ureter was duplicated in origin. CONCLUSION: This report shows that knowledge of anomalies such as this is very important in planning and conducting surgical procedures.