Osuga Keigo, Kishimoto Kentaro, Tanaka Kaishu, Nakamura Masahisa, Ono Yusuke, Maeda Noboru, Higashihara Hiroki, Nakazawa Tetsuro, Tomiyama Noriyuki
Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.
Department of Diagnostic Radiology, Osaka Cardiovascular and Cancer Center, Osaka, Japan.
Springerplus. 2014 Oct 17;3:609. doi: 10.1186/2193-1801-3-609. eCollection 2014.
The purpose of this study is to describe our initial experience with embolization of pulmonary arteriovenous malformations (PAVMs) using hydrogel microcoils. The technical and radiological outcomes were retrospectively reviewed in seven patients with nine simple-type PAVMs (median feeder size 4 mm, range 3-6 mm) who underwent embolization. Hydrogel microcoils were mainly used, and detachable bare microcoils were combined as needed to occlude the terminal feeding artery just before the sac. Of a total of 43 microcoils, 30 (69.8%) hydrogel microcoils were deployed in eight PAVMs with the median number 3.5 (range 2 to 6) per lesion. All hydrogel microcoils were successfully deployed without microcatheter stuck or malposition. In the remaining one small PAVM, only soft bare microcoils were used, however, resulting in recanalization requiring additional coils in the second session. The venous sac was substantially shrunk in all lesions treated with hydrogel microcoils with the median size reduction rate 95.0% (range 81.8% to 99.0%) during the median follow-up period 10 months (range 6 to 18 months). In conclusion, hydrogel microcoils were safely and effectively applied for occluding PAVMs with relatively small feeders.
本研究的目的是描述我们使用水凝胶微线圈栓塞肺动静脉畸形(PAVM)的初步经验。回顾性分析了7例患有9个单纯型PAVM(供血动脉中位数大小4mm,范围3 - 6mm)并接受栓塞治疗患者的技术和影像学结果。主要使用水凝胶微线圈,并根据需要联合使用可脱性裸微线圈以闭塞瘤囊前的终末供血动脉。在总共43个微线圈中,30个(69.8%)水凝胶微线圈用于8个PAVM,每个病变的中位数为3.5个(范围2至6个)。所有水凝胶微线圈均成功置入,未出现微导管嵌顿或位置不当。然而,在剩余的1个小PAVM中,仅使用了柔软的裸微线圈,导致再通,需要在第二次治疗时追加线圈。在中位随访期10个月(范围6至18个月)内,所有接受水凝胶微线圈治疗的病变中静脉瘤囊均明显缩小,中位数缩小率为95.0%(范围81.8%至99.0%)。总之,水凝胶微线圈可安全有效地用于闭塞供血动脉相对较小的PAVM。