title: Giant high-flow type pulmonary arteriovenous malformation: coil embolization with flow control by balloon occlusion and an anchored detachable coil.
abstract: Pulmonary arteriovenous malformations (PAVMs) are often treated by pushable fibered or non-fibered microcoils, using an anchor or scaffold technique or with an Amplatzer plug through a guiding sheath. When performing percutaneous transcatheter microcoil embolization, there is a risk of coil migration, particularly with high-flow type PAVMs. The authors report on a unique treatment in a patient with a giant high-flow PAVM whose nidus had a maximum diameter of 6 cm. A detachable coil, not detached from a delivery wire (an anchored detachable coil), was first placed in the feeding artery under flow control by balloon occlusion, and then multiple microcoils were packed proximally to the anchored detachable coil. After confirming the stability of the microcoils during a gradual deflation of the balloon, we finally released the first detachable coil. The nidus was reduced in size to 15 mm at one year postoperatively.
authors.affiliation: Department of Radiology, Gifu University Hospital, Gifu 501-1194, Japan. masa_gif@yahoo.co.jp
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanematsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kondo
authors.forename: Satoshi
authors.initials: S
authors.lastname: Goshima
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Tsuge
authors.forename: Haruo
authors.initials: H
authors.lastname: Watanabe
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Moriyama
mesh_terms: D001165:Arteriovenous Malformations / Q000628:therapy*; D021721:Balloon Occlusion / Q000379:methods*; D002404:Catheterization; D003287:Contrast Media; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media