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水凝胶涂层线圈在肺动静脉畸形栓塞中的应用价值

Usefulness of Hydrogel-Coated Coils in Embolization of Pulmonary Arteriovenous Malformations.

作者信息

Shimohira Masashi, Kawai Tatsuya, Hashizume Takuya, Muto Masahiro, Kitase Masanori, Shibamoto Yuta

机构信息

Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, 467-8601, Japan.

Department of Radiology, Nagoya City East Medical Center, Nagoya, 464-0071, Japan.

出版信息

Cardiovasc Intervent Radiol. 2018 Jun;41(6):848-855. doi: 10.1007/s00270-018-1876-5. Epub 2018 Jan 17.

Abstract

PURPOSE

To evaluate the usefulness of hydrogel-coated coils for preventing recanalization after coil embolization of pulmonary arteriovenous malformations (PAVMs).

MATERIALS AND METHODS

Thirty-seven consecutive patients with 57 untreated PAVMs underwent coil embolization with hydrogel-coated coils between January 2013 and Jun 2017. The mean age was 49 years (range 9-83 years), and there were seven male patients and 30 female patients. The median size of the feeding artery was 3.7 mm (range 1.5-6.1 mm), and the median size of the venous sac was 9.3 mm (range 2.6-36.6 mm). For all PAVM, embolization was attempted using 0.018-in. hydrogel-coated coils with or without other coils (0.0135-0.018-in. bare platinum coils and fibered platinum coils). Technical success rate, recanalization rate, and complications were evaluated. Technical success was defined as completion of embolization using hydrogel-coated coils. Recanalization was evaluated with time-resolved magnetic resonance angiography and/or pulmonary angiography.

RESULTS

In 56 of 57 PAVMs, embolization was successfully performed with hydrogel-coated coils. Therefore, the technical success rate was 98% (56/57). The number of PAVMs at risk was 56, 42, 18, and 12 at 0, 12, 24, and 36 months, respectively. There was no recanalization with a mean follow-up period of 19 months (range 2-47 months) in 56 PAVMs embolized with hydrogel-coated coils. There were no major complications. As a minor complication, local pain was observed in 8 of 43 sessions (19%) after embolization.

CONCLUSIONS

Hydrogel-coated coils may be useful for preventing recanalization after the embolization of PAVMs.

摘要

目的

评估水凝胶涂层线圈在预防肺动静脉畸形(PAVM)经线圈栓塞后再通方面的有效性。

材料与方法

2013年1月至2017年6月期间,37例连续的患者共57处未经治疗的PAVM接受了水凝胶涂层线圈栓塞治疗。平均年龄49岁(范围9 - 83岁),男性患者7例,女性患者30例。供血动脉的中位直径为3.7毫米(范围1.5 - 6.1毫米),静脉囊的中位直径为9.3毫米(范围2.6 - 36.6毫米)。对于所有PAVM,尝试使用0.018英寸的水凝胶涂层线圈,可联合或不联合其他线圈(0.0135 - 0.018英寸的裸铂线圈和纤维铂线圈)进行栓塞。评估技术成功率、再通率和并发症。技术成功定义为使用水凝胶涂层线圈完成栓塞。通过时间分辨磁共振血管造影和/或肺血管造影评估再通情况。

结果

57处PAVM中的56处成功使用水凝胶涂层线圈进行了栓塞。因此,技术成功率为98%(56/57)。在0、12、24和36个月时,有再通风险的PAVM数量分别为56、42、18和12处。56处接受水凝胶涂层线圈栓塞的PAVM平均随访期为19个月(范围2 - 47个月),均未出现再通。无严重并发症。作为轻微并发症,43次栓塞中有8次(19%)出现局部疼痛。

结论

水凝胶涂层线圈可能有助于预防PAVM栓塞后再通。

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