Scott O Trerotola1, Reed E Pyeritz. 1. Department of Radiology, Division of Vascular and Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St., Philadelphia, PA 19104, USA. streroto@uphs.upenn.edu
Abstract
OBJECTIVE: Recanalization has been reported with the use of a type 1 Amplatzer vascular plug as the sole device to manage a pulmonary arteriovenous malformation (PAVM). We evaluated our experience with the use of at least one coil in addition to the vascular plug whenever possible in the treatment of patients with a PAVM. MATERIALS AND METHODS: Thirty patients had 39 feeder vessels in 37 PAVMs managed with 39 type 1 Amplatzer vascular plugs. Eleven PAVMs (30%) were complex, and 26 (70%) were simple; nine (24%) were solitary. CT examinations were scheduled for 6 months after treatment and every 3-5 years thereafter. Scans were evaluated for persistent sac perfusion, sac shrinkage, and/or complete resolution of the PAVM. RESULTS: Complete occlusion of all PAVMs was achieved. The mean number of coils used in addition to a type 1 Amplatzer vascular plug was 1.5 (range, 0-5 coils). Six patients did not participate in follow-up; 24 patients with 28 PAVMs managed with type 1 Amplatzer vascular plugs underwent follow-up imaging (mean, 13 months after treatment; range, 6-40 months). No PAVM exhibited recanalization at follow-up CT. Sac shrinkage or disappearance was found in all cases, and the plug had a characteristic CT appearance. Longer-term surveillance imaging was scheduled for all patients. CONCLUSION: Used in conjunction with coils, the type 1 Amplatzer vascular plug offers excellent occlusion of PAVMs. No recanalization was found in this study.
OBJECTIVE: Recanalization has been reported with the use of a type 1 Amplatzer vascular plug as the sole device to manage a pulmonary arteriovenous malformation (PAVM). We evaluated our experience with the use of at least one coil in addition to the vascular plug whenever possible in the treatment of patients with a PAVM. MATERIALS AND METHODS: Thirty patients had 39 feeder vessels in 37 PAVMs managed with 39 type 1 Amplatzer vascular plugs. Eleven PAVMs (30%) were complex, and 26 (70%) were simple; nine (24%) were solitary. CT examinations were scheduled for 6 months after treatment and every 3-5 years thereafter. Scans were evaluated for persistent sac perfusion, sac shrinkage, and/or complete resolution of the PAVM. RESULTS: Complete occlusion of all PAVMs was achieved. The mean number of coils used in addition to a type 1 Amplatzer vascular plug was 1.5 (range, 0-5 coils). Six patients did not participate in follow-up; 24 patients with 28 PAVMs managed with type 1 Amplatzer vascular plugs underwent follow-up imaging (mean, 13 months after treatment; range, 6-40 months). No PAVM exhibited recanalization at follow-up CT. Sac shrinkage or disappearance was found in all cases, and the plug had a characteristic CT appearance. Longer-term surveillance imaging was scheduled for all patients. CONCLUSION: Used in conjunction with coils, the type 1 Amplatzer vascular plug offers excellent occlusion of PAVMs. No recanalization was found in this study.
Authors: Staci L Jessen; Molly C Friedemann; Anne-Marie Ginn-Hedman; Lance M Graul; Steven Jokerst; Cedric B Robinson; Todd L Landsman; Fred J Clubb; Duncan J Maitland Journal: ACS Biomater Sci Eng Date: 2019-09-23
Authors: Murthy R Chamarthy; Harold Park; Patrick Sutphin; Girish Kumar; Daniel Lamus; Sachin Saboo; Matthew Anderson; Sanjeeva P Kalva Journal: Cardiovasc Diagn Ther Date: 2018-06