title: Endovascular therapy of pulmonary arteriovenous malformations: Utility of 16-detector-row computed tomography pulmonary angiography as a pre-embolization survey.
abstract: The utility of computed tomography pulmonary angiography (CTPA) for coil embolization therapy of pulmonary arteriovenous malformations (PAVMs) was considered. Three consecutive patients (group A) with PAVMs underwent CTPA and coil embolization. The CTPA was performed using a 16-detector-row computed tomography scanner. After careful selection of pulmonary vessel trees, each feeding artery, nidus, and drainage vein was colored using different codes. By using the colored images, a 5-French catheter was shaped to fit to each feeding artery, the best fluoroscopic angle to select each feeding artery was chosen, and interlocking detachable coils (IDCs) were used in embolization. The procedure time and contrast material dose of group A were compared with those of the previous 3 patients (group B) who were treated by the conventional method. All PAVMs of both groups were completely embolized without coil migration. The average procedure time per lesion was 48.4 minutes for group A and 124.0 minutes for group B (P < 0.05). The average contrast material dose per lesion was 37.5 mL in group A and 76.0 mL in group B (P < 0.05). Using CTPA and IDCs, procedure time and contrast material dose were statistically significantly reduced. This combination therapy is useful in treating PAVMs less invasively.
authors.affiliation: Department of Radiology, Hiroshima University Hospital, Hiroshima, Japan. nhirai@hiroshima-u.ac.jp
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Hirai
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Toyota
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kakizawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Hieda
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tachikake
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujimura
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Ito
mesh_terms: D000328:Adult; D000368:Aged; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007472:Iohexol; D007479:Iopamidol; D008875:Middle Aged; D011651:Pulmonary Artery; D011667:Pulmonary Veins; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007472:Iohexol; D007479:Iopamidol