[Embolization of pulmonary arteriovenous malformations with electrolytically detachable coils in patients with hereditary hemorrhagic telangiectasia].
BACKGROUND
Pulmonary arteriovenous malformations (PAVM) can be found in approximately 20 % to 35 % of patients with hereditary hemorrhagic telangiectasia (HHT). PAVM should be treated since they are a source of paradoxical embolization, potentially resulting in severe neurologic complications. The treatment of choice is the endovascular embolization with coils.


METHODS
Seven patients with HHT underwent superselective embolization of PAVM detected during screening for PAVM. Four patients had a single PAVM and one patient 3, 4 and 5 PAVMs, respectively. Electrolytically detachable coils were used for embolization. In addition, coils with synthetic fibers were used during 6 embolizations for completion of embolization.


RESULTS
Embolization was technically successful in all patients. Complete primary occlusion was achieved in all PAVM. No coil migration or occlusion of unaffected pulmonary arteries was observed. After embolization, one patient developed a small pleural effusion, which was treated symptomatically.


CONCLUSIONS
As a minimally invasive procedure, superselective embolization is the treatment of choice in treating PAVM in patients with HHT. With the use of electrolytically detachable coils, the ideal coil size can be chosen and exact placement achieved without the risk of coil migration or occlusion of unaffected pulmonary arteries.
Kress
O
O
Klinik für Strahlendiagnostik, Philipps-Universität Marburg, Baldingerstrasse, 35033 Marburg. kresso@med.uni-marburg.de
Wollstein
A C
AC
Wagner
H-J
HJ
Folz
B J
BJ
Werner
J A
JA
Klose
K J
KJ
Alfke
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001165:Arteriovenous Malformations / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D013902:Radiography, Thoracic; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000628:therapy*; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed
Embolisation pulmonaler arteriovenöser Malformationen bei hereditärer hämorrhagischer Teleangiektasie mittels elektrolytisch ablösbarer Spiralen.