Transcatheter embolization of pulmonary arteriovenous malformations in Rendu-Osler-Weber disease.

Interest in the treatment of the pulmonary arteriovenous malformations (PAVMs) that occur in approximately one-third of patients with Rendu-Osler-Weber (ROW) disease (hereditary haemorrhagic telangiectasia) has recently been renewed. PAVMs can now be occluded safely by the transvenous placement of detachable balloons or metal coils, thus avoiding the many potential complications of thoracotomy. This study analyses the treatment of eight PAVMs in four ROW patients by transcatheter embolization using detachable balloons or metal coils. After embolization, the mean right-to-left shunt fraction significantly decreased from 39.1 +/- 5.1% to 11.9 +/- 1.1% (P < 0.05) and PaO2 significantly increased from 53.3 +/- 7.8 torr to 76.2 +/- 8.4 torr (P < 0.05). No serious complications occurred. One detachable balloon was deflated, but no recanalization occurred. We conclude that transcatheter embolization is a safe and efficacious treatment for PAVMs associated with ROW disease. Long-term studies are now needed to determine the risk of recanalization in this treatment.