Department of Radiology, Division of Vascular and Interventional Radiology, University of Pennsylvania Medical Center, 1 Silverstein, 3400 Spruce St., Philadelphia, PA 19104, USA.
AJR Am J Roentgenol. 2010 Sep;195(3):766-71. doi: 10.2214/AJR.09.3953.
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.
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.
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.
Used in conjunction with coils, the type 1 Amplatzer vascular plug offers excellent occlusion of PAVMs. No recanalization was found in this study.
据报道，使用 1 型 Amplatzer 血管塞作为唯一装置可复通肺动静脉畸形（PAVM）。我们评估了在治疗 PAVM 患者时尽可能使用血管塞加至少一根线圈的经验。
30 例患者 37 个 PAVM 的 39 个供血血管使用 39 个 1 型 Amplatzer 血管塞治疗。11 个 PAVM（30%）为复杂型，26 个（70%）为简单型；9 个（24%）为单发。治疗后 6 个月和之后每 3-5 年进行 CT 检查。扫描评估囊腔持续灌注、囊腔缩小和/或 PAVM 完全消退情况。
所有 PAVM 均达到完全闭塞。除 1 型 Amplatzer 血管塞外，平均使用 1.5 个（范围 0-5 个）线圈。6 例患者未参与随访；24 例患者（28 个 PAVM）接受 1 型 Amplatzer 血管塞治疗后进行了随访成像（平均治疗后 13 个月；范围 6-40 个月）。在随访 CT 上未发现 PAVM 复通。所有病例均发现囊腔缩小或消失，塞子有特征性 CT 表现。所有患者均计划进行长期随访成像。
1 型 Amplatzer 血管塞与线圈联合使用可实现 PAVM 的良好闭塞。本研究中未发现复通。
