Prediction of the effect of injected ethanol on pulmonary arterial pressure during sclerotherapy of arteriovenous malformations: relationship with dose of ethanol.
OBJECTIVE
To prospectively evaluate the effect of injected ethanol on pulmonary artery pressure during embolosclerotherapy of arteriovenous malformations (AVMs).


METHODS
This prospective study was conducted in 16 male and 14 female patients (37 sessions; mean age, 34 years; age range, 17-67 years) with AVMs during a 2-year period. The authors measured pulmonary artery pressure via a pulmonary artery catheter and ethanol levels from the pulmonary and radial arteries simultaneously within 3 minutes after each ethanol injection. The authors analyzed the relationship between pulmonary artery pressure and ethanol levels obtained from pulmonary and radial arteries with respect to both single and cumulative doses of ethanol injected. Retrospectively, patients were divided into two groups-those treated with and those treated without vascular occlusion techniques.


RESULTS
The radial arterial ethanol level showed good correlation with the pulmonary arterial ethanol level (r = 0.7). Single dose per injection was statistically related with pulmonary artery pressure (r = 0.5 vs 0.1 and P < .05 vs .29, respectively, in patients treated without and patients treated with vascular occlusion techniques), and the correlation coefficient between cumulative dose and pulmonary artery pressure was 0.2 and 0.3 in respective cases (P < .05 for both). The mean pulmonary artery pressure correlated with pulmonary arterial ethanol level irrespective of the use of vascular occlusion (r = 0.6 for both groups).


CONCLUSIONS
Pulmonary artery pressure reflected the pulmonary arterial ethanol level and was positively related to the dose of ethanol. Single dose per injection was predictive of pulmonary artery pressure only in patients treated without vascular occlusion techniques.
Ko
Justin S
JS
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
Kim
Jie A
JA
Do
Young S
YS
Kwon
Min A
MA
Choi
Soo J
SJ
Gwak
Mi S
MS
Lee
Jeong J
JJ
Yang
Mikyung
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001165:Arteriovenous Malformations / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000187:drug effects* / Q000503:physiopathology; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy; D016896:Treatment Outcome; D055815:Young Adult
D012597:Sclerosing Solutions; D000431:Ethanol