Shimohira Masashi, Kawai Tatsuya, Hashizume Takuya, Muto Masahiro, Kitase Masanori, Shibamoto Yuta
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.
Cardiovasc Intervent Radiol. 2018 Jun;41(6):848-855. doi: 10.1007/s00270-018-1876-5. Epub 2018 Jan 17.
To evaluate the usefulness of hydrogel-coated coils for preventing recanalization after coil embolization of pulmonary arteriovenous malformations (PAVMs).
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.
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.
Hydrogel-coated coils may be useful for preventing recanalization after the embolization of PAVMs.
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。
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。
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。
水凝胶涂层线圈可能有助于预防PAVM栓塞后再通。
