D A F van den Heuvel, S Klompmaker, J Hessels, A D Diederik, J J Mager, J C van den Berg, M C Post
{"title":"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。","authors":"D A F van den Heuvel, S Klompmaker, J Hessels, A D Diederik, J J Mager, J C van den Berg, M C Post","doi":"10.1016/j.jvir.2025.09.024","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":49962,"journal":{"name":"Journal of Vascular and Interventional Radiology","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pulmonary Arteriovenous Malformation embolization: The role of Contrast-Enhanced Computed Tomography and Standardized Outcome Measures.\",\"authors\":\"D A F van den Heuvel, S Klompmaker, J Hessels, A D Diederik, J J Mager, J C van den Berg, M C Post\",\"doi\":\"10.1016/j.jvir.2025.09.024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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).</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":49962,\"journal\":{\"name\":\"Journal of Vascular and Interventional Radiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-09-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Vascular and Interventional Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jvir.2025.09.024\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Vascular and Interventional Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jvir.2025.09.024","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
Pulmonary Arteriovenous Malformation embolization: The role of Contrast-Enhanced Computed Tomography and Standardized Outcome Measures.
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.
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.
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