Grosso M, Groppo Marchisio F, Testa F, Gallarato G, Balderi A, Lingua G, Mondino I, Pedrazzini F, Danesino C, Buscarini E
Dipartimento Radiologico, S.C. Radiodiagnostica, Azienda Ospedaliera S.Croce e Carle, Via Coppino 26, Cuneo, Italy.
Radiol Med. 2008 Apr;113(3):395-413. doi: 10.1007/s11547-008-0261-x. Epub 2008 Jul 9.
The aim of our study was to illustrate the benefits of percutaneous treatment by embolisation of high-flow pulmonary arteriovenous malformations (PAVM) in patients suffering from hereditary haemorrhagic telangiectasia (HHT; Rendu-Osler-Weber disease).
From December 2001 to February 2007, we embolised 60 PAVMS in 35 procedures performed on 30 patients, all referred by the HHT centre in Crema, and enrolled in a screening programme of HHT families. All patients underwent clinical evaluation, contrast-enhanced ultrasound (CEUS) and spiral computed tomography (CT). Embolisation was made with nonmagnetic metallic coils via femoral venous access; an endovascular Amplatzer device was used in one patient only.
All embolisations were performed without difficulty. One patient only developed partial temporary aphasia, which resolved in 72 H. At spiral-CT follow-up, we generally demonstrated exclusion from circulation of treated PAVMS and regression of clinical symptoms. In the case of new lesions or recanalisation, further embolisation was possible:
Percutaneous embolisation has recently become the initial treatment option in PAVM owing to its good results and minimal invasiveness compared with thoracotomy. Our experience is in agreement with the literature: the procedure has a low complication rate, provides very good technical and clinical results and avoids resection of healthy pulmonary parenchyma.
我们研究的目的是阐述对患有遗传性出血性毛细血管扩张症（HHT；伦杜-奥斯勒-韦伯病）的患者进行经皮栓塞高流量肺动静脉畸形（PAVM）治疗的益处。
从2001年12月至2007年2月，我们对30例患者进行了35次操作，栓塞了60个PAVM，所有患者均由克雷马的HHT中心转诊，并纳入HHT家族筛查项目。所有患者均接受了临床评估、对比增强超声（CEUS）和螺旋计算机断层扫描（CT）检查。通过股静脉途径用非磁性金属线圈进行栓塞；仅1例患者使用了血管内Amplatzer装置。
所有栓塞操作均顺利完成。仅1例患者出现部分暂时性失语，72小时后症状缓解。在螺旋CT随访中，我们通常证实已治疗的PAVM被排除在循环之外，临床症状有所缓解。对于新出现的病变或再通情况，可进行进一步栓塞：
与开胸手术相比，经皮栓塞由于效果良好且创伤极小，最近已成为PAVM的首选治疗方法。我们的经验与文献一致：该手术并发症发生率低，技术和临床效果非常好，且避免了对健康肺实质的切除。
