Please use this identifier to cite or link to this item: doi:10.22028/D291-43841
Title: Reperfusion of Pulmonary Arteriovenous Malformations Treated by Catheter Embolization
Author(s): Gulich, Bianca
Buecker, Arno
Schneider, Guenther
Language: English
Title: Journal of Clinical Medicine
Volume: 13
Issue: 24
Publisher/Platform: MDPI
Year of Publication: 2024
Free key words: hereditary hemorrhagic telangiectasia (HHT)
arteriovenous malformations
embolization
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: Objective: The aim of this study was to evaluate patients with hereditary hemorrhagic telangiectasia (HHT) for the potential reperfusion of pulmonary arteriovenous malformations (PAVM) treated by catheter embolization using coils or embolization plugs and to analyze causes of possible reperfusion in order to further improve treatment. Methods: This retrospective study analyzed the data of 345 patients who underwent screening for pulmonary arteriovenous malformations in cases of suspected or confirmed HHT (Osler’s disease). Of these, 118 patients with PAVM that underwent catheter embolization and had at least one follow-up study were included in our study and evaluated for potential reperfusion. Screening and follow-up for the detection of PAVM was performed by dynamic and high-resolution contrast-enhanced magnetic resonance angiography (MRA). The average follow-up time was 6.2 years. Results: Reperfusion was detected in 43 of 118 patients at follow-up. Thirty-five of these patients showed a recanalization of the treated vessel and in eleven patients the formation of collateral vessels resupplying the PAVM were identified as the cause of reperfusion. The average time between embolization and detected reperfusion was 5.6 years. The recanalization of both coils and plugs was observed. The recanalization of coils could be attributed in most cases to an insufficient packing density of the implanted coils. In addition, an enlarged diameter of the feeding artery was confirmed as a risk factor for reperfusion. Conclusions: As the reperfusion of embolized pulmonary arteriovenous malformations can occur after a long time interval post-treatment, regular lifelong follow-up studies after embolization are essential to detect reperfusion at an early stage and avoid serious complications like a brain abscess or stroke through prompt re-embolization. After coil embolization, attention should be paid to sufficiently dense packing to achieve adequate and permanent occlusion.
DOI of the first publication: 10.3390/jcm13247812
URL of the first publication: https://doi.org/10.3390/jcm13247812
Link to this record: urn:nbn:de:bsz:291--ds-438418
hdl:20.500.11880/39340
http://dx.doi.org/10.22028/D291-43841
ISSN: 2077-0383
Date of registration: 10-Jan-2025
Faculty: M - Medizinische Fakultät
Department: M - Radiologie
Professorship: M - Keiner Professur zugeordnet
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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