Wingen M, Günther R W
Klinik für Radiologische Diagnostik, RWTH Aachen.
Rofo. 2001 Jul;173(7):606-11. doi: 10.1055/s-2001-15834.
Evaluation of technical success, complications and long-term results of transcatheter coil embolisation in pulmonary arteriovenous malformations (pAVMs).
Transcatheter embolisations of 46 pAVMs in 14 patients were analysed retrospectively, and, 5 years after treatment, the patients were interviewed by telephone concerning persistent symptoms and complications. Main symptoms before embolisation were dyspnoe (86%), hypoxaemia (100%), cerebral ischemia (21%), and hemoptysis (14%); 11 patients (79%) suffered from hereditary hemorrhagic telangiectasia.
Embolisation with an average of 3.9 coils (min. 1, max. 19 coils) per pAVM yielded technical success in all cases. Only two minor complications, transitory pleuritis and a small lung infarction were observed. On follow up examination after 5 years either no residual complaints or substantial improvement of dyspnoe were reported; no patient suffered from neurologic or hemorrhagic complications after the embolisation.
Transcatheter embolisation is a safe and minimally invasive therapy for pAVMs and has rightfully replaced surgical resection as the therapy of choice.
评估经导管弹簧圈栓塞治疗肺动静脉畸形(pAVM)的技术成功率、并发症及长期疗效。
回顾性分析14例患者46处pAVM的经导管栓塞治疗情况,治疗5年后通过电话随访患者持续存在的症状及并发症。栓塞前主要症状为呼吸困难(86%)、低氧血症(100%)、脑缺血(21%)及咯血(14%);11例患者(79%)患有遗传性出血性毛细血管扩张症。
每处pAVM平均使用3.9枚弹簧圈(最少1枚,最多19枚)进行栓塞,所有病例均取得技术成功。仅观察到2例轻微并发症,即短暂性胸膜炎和小面积肺梗死。5年随访检查时,要么无残留症状,要么呼吸困难有显著改善;栓塞后无患者出现神经或出血性并发症。
经导管栓塞是治疗pAVM的一种安全且微创的治疗方法,已理所当然地取代手术切除成为首选治疗方法。