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使用大容量可脱卸无纤维线圈栓塞初发性肺动静脉畸形:与传统线圈的倾向匹配比较

Embolization of De Novo Pulmonary Arteriovenous Malformations Using High-Volume Detachable Non-Fibered Coils: Propensity-Matched Comparison to Traditional Coils.

作者信息

Mathevosian Sipan, Sparks Hiro D, Cusumano Lucas R, Roberts Dustin G, Majumdar Shamaita, McWilliams Justin P

机构信息

Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA.

出版信息

J Clin Med. 2024 Jan 23;13(3):648. doi: 10.3390/jcm13030648.

Abstract

Embolization of de novo pulmonary arteriovenous malformations (PAVMs) using high-volume detachable non-fibered (HVDNF) coils was compared to traditional non-HVDNF coils. Persistent-occlusion rates were evaluated. A total of 272 de novo (previously untreated) PAVM treatments were retrospectively stratified into those treated with non-HVDNF coils only ( = 192) and those treated with HVDNF coils with or without other coils ( = 80). Propensity score matching, followed by survival analysis and cost analysis, was performed. The overall persistent-occlusion rate was 86.0% (234/272). Persistent occlusion was achieved in 81.8% of PAVMs using non-HVDNF coils, compared with 96.3% using HVDNF coils ( = 0.0017). The mean follow-up was 30.7 ± 31.9 months versus 14.7 ± 13.4 months, respectively ( < 0.0001). Propensity-matched survival analysis demonstrated PAVMs treated with HVDNF coils recurred significantly less frequently than PAVMs treated with non-HVNDF coils ( = 0.023). The use of HVDNF coils was more expensive than standard coils, however not significantly different for the treatment of complex PAVMs. The use of high-volume detachable non-fibered coils was associated with higher persistent-occlusion rates when compared with non-HVDNF coils. HVDNF coils were more expensive on average; however, cost was similar between groups for the treatment of complex PAVMs.

摘要

将使用大容量可脱卸无纤维(HVDNF)线圈栓塞初发性肺动静脉畸形(PAVM)与传统的非HVDNF线圈进行比较。评估持续闭塞率。总共272例初发性(既往未治疗)PAVM治疗被回顾性分层为仅用非HVDNF线圈治疗的患者(n = 192)和用HVDNF线圈联合或不联合其他线圈治疗的患者(n = 80)。进行倾向评分匹配,随后进行生存分析和成本分析。总体持续闭塞率为86.0%(234/272)。使用非HVDNF线圈的PAVM中81.8%实现了持续闭塞,而使用HVDNF线圈的为96.3%(P = 0.0017)。平均随访时间分别为30.7±31.9个月和14.7±13.4个月(P<0.0001)。倾向匹配生存分析表明,用HVDNF线圈治疗的PAVM复发频率明显低于用非HVDNF线圈治疗的PAVM(P = 0.023)。使用HVDNF线圈比标准线圈更昂贵,然而在治疗复杂PAVM方面无显著差异。与非HVDNF线圈相比,使用大容量可脱卸无纤维线圈与更高的持续闭塞率相关。HVDNF线圈平均更昂贵;然而,在治疗复杂PAVM时两组之间成本相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/037b/10856390/e1166ad497fe/jcm-13-00648-g001.jpg

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