Hirota S, Matsumoto S, Tomita M, Sako M, Kono M
Central Division of Radiology, Kobe University School of Medicine, Japan.
Radiat Med. 1998 Jan-Feb;16(1):17-23.
The aim of this study was to assess the effectiveness of percutaneous treatment of PAVFs through the results of long-term follow-up.
Transcatheter embolization of PAVFs using spring coils was performed in seven patients (six women and one man) with nine PAVFs, between 1989 and 1995, who were followed up at least one year. The size of the nine PAVFs ranged from 4 mm to 70 mm in diameter (mean 26 mm). Two fistulas were huge, 70 x 45 mm and 60 x 65 mm in diameter. Embolization was performed twice in three patients and once in four patients. In the two patients with huge PAVFs, after anchoring metallic "spiders" into the feeding artery, the largest coils were positioned and entangled with the "spider" followed by the placement of smaller coils to fill in the center of the feeding artery.
No severe complications were seen in the short-term follow-up. Arterial oxygen pressure improved in all patients with low oxygen pressure. Five patients with seven fistulas, six of which disappeared on chest X-ray film, are still alive after follow-up ranging from one year and 10 months to seven years and nine months. The two patients with huge fistulas died more than one year after treatment, one of hemoptysis of the contralateral lung and the other of pulmonary fibrosis.
Complete embolization of a medium-sized feeding artery can cure this anomaly.
本研究旨在通过长期随访结果评估经皮治疗肺动静脉瘘（PAVF）的有效性。
1989年至1995年间，对7例（6例女性，1例男性）患有9个PAVF的患者进行了经导管弹簧圈栓塞治疗，并对其进行了至少一年的随访。9个PAVF的直径范围为4毫米至70毫米（平均26毫米）。两个瘘口巨大，直径分别为70×45毫米和60×65毫米。3例患者进行了两次栓塞，4例患者进行了一次栓塞。在两名患有巨大PAVF的患者中，先将金属“蜘蛛”锚定在供血动脉中，然后放置最大的弹簧圈并与“蜘蛛”缠绕，接着放置较小的弹簧圈以填充供血动脉的中心。
短期随访中未见严重并发症。所有低氧压患者的动脉血氧分压均有所改善。7个瘘口的5例患者，其中6个瘘口在胸部X线片上消失，随访时间为1年10个月至7年9个月，这些患者仍然存活。两名患有巨大瘘口的患者在治疗一年多后死亡，其中一名死于对侧肺咯血，另一名死于肺纤维化。
对中等大小的供血动脉进行完全栓塞可治愈这种异常情况。
