Pulmonary Arteriovenous Malformation embolization: The role of Contrast-Enhanced Computed Tomography and Standardized Outcome Measures.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2025-09-20 DOI:10.1016/j.jvir.2025.09.024

D A F van den Heuvel, S Klompmaker, J Hessels, A D Diederik, J J Mager, J C van den Berg, M C Post

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引用次数: 0

Abstract

Purpose: To determine the pulmonary arteriovenous malformation (PAVM) persistence rate in patients treated with microcoils, vascular plugs, or a combination of these, and to propose standardized outcome criteria using contrast-enhanced computed tomography (CECT).

Materials and methods: This retrospective study included all adult patients undergoing embolization of de novo PAVMs using micro-coils and/or Amplatzer type I vascular plugs (AVP-I), between 2005 and 2012. PAVM persistence was assessed at 6 months using CECT, focussing on vein enhancement vs shrinkage rates. Endpoints were overall persistence and persistence in technically successful treated de novo PAVMs. This was defined as confirmed occlusion of all embolized feeding arteries, embolization ≤10 mm of the sac and without missed feeding arteries.

Results: The study included 113 patients (mean age 42±18 years, 63 female) representing 292 PAVMs for analysis. Persistence was observed in 82 of 292 (28%) PAVMs and was angiographically confirmed in all cases. Of the persistent PAVMs, 16% showed >70% sac shrinkage on CECT. Among 108 technically successful treated simple PAVMs, overall persistence was 11% (7% for AVP-I and 21% for coils).

Conclusion: Based on CECT and with angiographical confirmation, overall PAVM persistence at 6 months after embolization with coils or AVPs was 28%. A suspected high sensitivity of CECT for detecting PAVM persistence may partially account for outcome differences compared to previous studies and underscores the need for standardized imaging and reporting protocols.

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肺动静脉畸形栓塞：对比增强计算机断层扫描和标准化结果测量的作用。

目的：确定接受微线圈、血管塞或两者联合治疗的患者的肺动静脉畸形（PAVM）持续率，并使用对比增强计算机断层扫描（CECT）提出标准化的结果标准。材料和方法：本回顾性研究纳入了2005年至2012年间使用微线圈和/或Amplatzer I型血管塞（AVP-I）栓塞新生pavm的所有成年患者。在6个月时使用CECT评估PAVM持续性，重点是静脉增强和收缩率。终点是总体持久性和技术上成功治疗的新发pavm的持久性。这被定义为确认所有栓塞的供血动脉闭塞，栓塞≤10毫米囊，没有遗漏的供血动脉。结果：研究纳入113例患者（平均年龄42±18岁，女性63例），共292例pavm进行分析。292例pavm中有82例（28%）存在持续性，所有病例均经血管造影证实。在持续性pavm中，16%在CECT上显示bbb70 %的囊缩小。在108例技术上成功治疗的单纯pavm中，总体持久性为11% （AVP-I组为7%，线圈组为21%）。结论：基于CECT和血管造影证实，在线圈或avp栓塞后6个月，PAVM的总体持久性为28%。与之前的研究相比，CECT检测PAVM持久性的高灵敏度可能部分解释了结果差异，并强调了标准化成像和报告协议的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.