scholarly journals Contemporary Management of Pulmonary Arteriovenous Malformations

2017 ◽  
Vol 26 (04) ◽  
pp. 205-211 ◽  
Author(s):  
Nicholas Rauh ◽  
John Gurley ◽  
Sibu Saha
Keyword(s):  
Arteriovenous Malformations ◽  
Transcatheter Embolization ◽  
Diagnostic Methods ◽  
Pulmonary Arteriovenous Malformations ◽  
Operative Techniques ◽  
University Of Kentucky ◽  
Vascular Structures ◽  
Pulmonary Arterial ◽  
Contemporary Management ◽  
The University

AbstractPulmonary arteriovenous malformations (PAVMs) are atypical vascular structures involving a direct connection between the pulmonary arterial and venous circulations. While PAVMs are a relatively uncommon disorder, unmanaged cases are at risk for the development of serious complications including embolization and infection. Since their first description in 1897, PAVMs have been identified and treated in a variety of ways. Advancements in diagnostic methods and operative techniques have allowed for more effective treatment of the disease. Most recently, the use of vascular plug transcatheter embolization has been described as an effective therapeutic procedure in the management of PAVMs. In this report, we present our experience with nine cases of PAVMs treated at the University of Kentucky, including special consideration of an exemplary case that illustrates the typical course of treatment for the disease.

scholarly journals Evaluation of percutaneous transcatheter embolization for pulmonary arteriovenous malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
ZhengZhong Wu ◽  
JunQing Lin ◽  
WeiZhu Yang ◽  
Na Jiang ◽  
Ning Huang ◽  
...  
Keyword(s):  
New York ◽  
Success Rate ◽  
Arteriovenous Malformations ◽  
Heart Association ◽  
Transcatheter Embolization ◽  
Pulmonary Arteriovenous Malformations ◽  
Technical Success ◽  
Arterial Blood Gas ◽  
Technical Success Rate ◽  
Arterial Blood

Abstract Background The purpose of this study was to assess the safety and efficacy of percutaneous transcatheter embolization (TCE) for the treatment of pulmonary arteriovenous malformations (PAVMs). Methods Forty-three consecutive patients (n = 17 males; n = 26 females) with 72 untreated PAVMs underwent coil and/or plug embolization between January 2010 and February 2018. The mean patient age was 42 ± 14 years (range 19–71 years). The median size of the feeding artery was 7.9 ± 2.9 mm (range 3.5–14.0 mm). The arterial blood gas level and cardiac function of all patients were analysed. The technical success rate, recanalization rate, and complications were evaluated. Computed tomography angiography (CTA) examinations were scheduled for 12 months after treatment and every 2–4 years thereafter. Results Twenty-five PAVMs were treated with coils alone, twenty-one were treated with plugs alone, and twenty-six were treated with both coils and plugs. The technical success rate was 100%. There were no complications during operation. However, one patient (2.3%) had pulmonary thrombosis and embolism post-operation. The patients’ pre-operative and post-operative PaO2 and SaO2 levels were significantly different (p < 0.01). A comparison of the New York Heart Association (NYHA) grade before and after embolization in all patients showed a significant decrease in the post-operative grade (p < 0.01). The 72 PAVMs were divided into three groups (coils only group [n = 25], plugs only group [n = 21], and coils/plugs combined group [n = 26]). After 12 months of follow-up, there were seven reperfusion PAVMs in the coil group, seven reperfusion PAVMs in the plug group, and 1 reperfusion PAVM in the combined group. There were significant differences between the two groups and the combined group. Conclusion Percutaneous TCE is safe and effective for the treatment of PAVMs. A combination of coils and vascular plugs may be useful for preventing recanalization after the embolization of PAVMs.

Transcatheter embolization of pulmonary arteriovenous malformations in Rendu-Osler-Weber disease

Respirology ◽  
1998 ◽  
Vol 3 (4) ◽  
pp. 277-280 ◽  
Author(s):  
Takanobu SHIOYA ◽  
Masa-Aki SANO ◽  
Manabu KAGAYA ◽  
Nobuaki ITO ◽  
Akiko WATANABE ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Transcatheter Embolization ◽  
Pulmonary Arteriovenous Malformations

The role of angiogenesis in the development of pulmonary arteriovenous malformations in children after cavopulmonary anastomosis

1997 ◽  
Vol 7 (4) ◽  
pp. 370-374 ◽  
Author(s):  
Blair Marshall ◽  
Brian W. Duncan ◽  
Richard A. Jonas
Keyword(s):  
Arteriovenous Malformations ◽  
Fontan Procedure ◽  
Pulmonary Arteriovenous Malformations ◽  
Arterial Circulation ◽  
Clinical Observations ◽  
Bidirectional Glenn Shunt ◽  
Cavopulmonary Anastomosis ◽  
Pulmonary Arterial ◽  
End Stage

AbstractPulmonary arteriovenous malformations are a frequent cause of progressive cyanosis after construction of a cavopulmonary anastomosis. Their formation complicates the management of children with single ventricle physiology after a bidirectional Glenn shunt or the Kawashima procedure. The key role of the liver in this phenomenon is suggested by the observation that providing modifications of the Fontan procedure which permit hepatic venous effluent to reach the pulmonary arterial circulation limit further development of the malformations. In addition, it is known that patients with end-stage hepatic failure develop pulmonary arteriovenous malformations that diminish after liver transplantation. We have begun purification of a factor derived from hepatocyte-conditioned media that is inhibitory for the proliferation of cultured endothelial cells. This substance is heat sensitive, and binds avidly to a copper-containing chromatography column. These clinical observations, and this preliminary experimental work, support the concept that hepatic-derived angiogenic factors may play a role in the development of pulmonary arteriovenous malformations after construction of cavopulmonary anastomoses.

scholarly journals Where is the Origin of the Last Normal Branch from Feeding Artery of Pulmonary Arteriovenous Malformations?

2018 ◽  
Vol 41 (12) ◽  
pp. 1849-1856
Author(s):  
Miyuki Maruno ◽  
Hiro Kiyosue ◽  
Norio Hongo ◽  
Shunro Matsumoto ◽  
Hiromu Mori
Keyword(s):  
Arteriovenous Malformations ◽  
High Flow ◽  
Pulmonary Arteriovenous Malformations ◽  
Feeding Artery ◽  
Special Interests ◽  
Level Of Evidence ◽  
Pulmonary Arteriography ◽  
Normal Branch ◽  
Level 3 ◽  
Pulmonary Arterial

Abstract Purpose Reperfusion via pulmonary-to-pulmonary arterial anastomoses is known as one type of recurrence of pulmonary arteriovenous malformations (PAVMs) after embolization. It is important to occlude the fistulous portion beyond the origin of the last normal branch from feeding artery of PAVMs to prevent recurrence. In this study, we evaluate the origin of the last normal branch by CT as well as its visibility on pulmonary arteriography (PAG). Materials and Methods We reviewed forty patients with 77 PAVMs who underwent coil embolization between October 2007 and December 2017. All patients underwent MDCT before embolization. Axial and MPR CT lung images were reviewed with special interests in the origin of the last normal branch from feeding artery of PAVMs. The origin was classified into three portions, including sac, junction (portion just proximal to the sac) and proximal feeder (more than 5 mm proximal to the sac). We also evaluated whether PAG can depict the normal branches detected by MDCT. Results MDCT showed that the last normal branch originated from sac in 30 PAVMs (39.0%), junction in 39 (50.6%), and proximal feeder in 8 (10.4%).On selective PAG, the last normal branch could be visualized in 30 PAVMs (39.0%), although it could not be visualized due to high-flow shunt in the other 47 PAVMs. Conclusions Selective PAG frequently fails to demonstrate the last normal branch from feeding artery of PAVMs, which often originates from the sac. Pretherapeutic evaluation of CT images of the last normal branch is important to prevent reperfusion of PAVMs. Level of Evidence Level 3, local non-random sample.

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