Embolotherapy of large pulmonary arteriovenous malformations

Long-term results

Daniel W. Lee, Robert I. White, Thomas K. Egglin, Jeffrey S. Pollak, Pierre B Fayad, Joel A. Wirth, Melvin M. Rosenblatt, Kevin W. Dickey, Catherine M. Burdge

Research output: Contribution to journalArticle

216 Citations (Scopus)

Abstract

Background. The purpose of this study was to document the long-term results of transcatheter embolotherapy of large pulmonary arteriovenous malformations (PAVMs). Methods. From a data base of 221 consecutive patients with PAVMs treated by embolotherapy between 1978 and 1995, 45 patients with 52 PAVMs, supplied by feeding arteries 8 mm in diameter or larger, were selected for a retrospective investigation. Results. Of 48 patients with 52 large PAVMs, 38 patients (84%) with 44 PAVMs (85%) were cured by the first embolotherapy (mean follow-up, 4.7 years). Acute periprocedural complications included self-limited pleurisy (31%), angina secondary to air embolus (2%), and paradoxical embolization of a device during deployment (4%). None of these events led to short- or long-term sequelae. Seven patients (16%) had persistence of the PAVM attributable to either recanalization (n = 4) or interim accessory artery growth (n = 3). Two of these patients presented with ischemic stroke several years after the initial treatment. Persistent PAVMs (n = 8) were retreated successfully by a second procedure (n = 7), or a third procedure (n = 1) (mean follow-up, 5.9 and 5.3 years, respectively). Conclusions. Embolotherapy of large PAVMs results in permanent occlusion in an overwhelming majority of patients. Continued patency due to recanalization or accessory artery growth is easily detected and treated.

Original languageEnglish (US)
Pages (from-to)930-940
Number of pages11
JournalAnnals of Thoracic Surgery
Volume64
Issue number4
DOIs
StatePublished - Oct 1 1997

Fingerprint

Therapeutic Embolization
Arteriovenous Malformations
Lung
Arteries
Pleurisy
Growth
Embolism
Stroke
Air
Databases
Equipment and Supplies

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Lee, D. W., White, R. I., Egglin, T. K., Pollak, J. S., Fayad, P. B., Wirth, J. A., ... Burdge, C. M. (1997). Embolotherapy of large pulmonary arteriovenous malformations: Long-term results. Annals of Thoracic Surgery, 64(4), 930-940. https://doi.org/10.1016/S0003-4975(97)00815-1

Embolotherapy of large pulmonary arteriovenous malformations : Long-term results. / Lee, Daniel W.; White, Robert I.; Egglin, Thomas K.; Pollak, Jeffrey S.; Fayad, Pierre B; Wirth, Joel A.; Rosenblatt, Melvin M.; Dickey, Kevin W.; Burdge, Catherine M.

In: Annals of Thoracic Surgery, Vol. 64, No. 4, 01.10.1997, p. 930-940.

Research output: Contribution to journalArticle

Lee, DW, White, RI, Egglin, TK, Pollak, JS, Fayad, PB, Wirth, JA, Rosenblatt, MM, Dickey, KW & Burdge, CM 1997, 'Embolotherapy of large pulmonary arteriovenous malformations: Long-term results', Annals of Thoracic Surgery, vol. 64, no. 4, pp. 930-940. https://doi.org/10.1016/S0003-4975(97)00815-1
Lee, Daniel W. ; White, Robert I. ; Egglin, Thomas K. ; Pollak, Jeffrey S. ; Fayad, Pierre B ; Wirth, Joel A. ; Rosenblatt, Melvin M. ; Dickey, Kevin W. ; Burdge, Catherine M. / Embolotherapy of large pulmonary arteriovenous malformations : Long-term results. In: Annals of Thoracic Surgery. 1997 ; Vol. 64, No. 4. pp. 930-940.
@article{b45d0ad7677840e0ba52276e73a25250,
title = "Embolotherapy of large pulmonary arteriovenous malformations: Long-term results",
abstract = "Background. The purpose of this study was to document the long-term results of transcatheter embolotherapy of large pulmonary arteriovenous malformations (PAVMs). Methods. From a data base of 221 consecutive patients with PAVMs treated by embolotherapy between 1978 and 1995, 45 patients with 52 PAVMs, supplied by feeding arteries 8 mm in diameter or larger, were selected for a retrospective investigation. Results. Of 48 patients with 52 large PAVMs, 38 patients (84{\%}) with 44 PAVMs (85{\%}) were cured by the first embolotherapy (mean follow-up, 4.7 years). Acute periprocedural complications included self-limited pleurisy (31{\%}), angina secondary to air embolus (2{\%}), and paradoxical embolization of a device during deployment (4{\%}). None of these events led to short- or long-term sequelae. Seven patients (16{\%}) had persistence of the PAVM attributable to either recanalization (n = 4) or interim accessory artery growth (n = 3). Two of these patients presented with ischemic stroke several years after the initial treatment. Persistent PAVMs (n = 8) were retreated successfully by a second procedure (n = 7), or a third procedure (n = 1) (mean follow-up, 5.9 and 5.3 years, respectively). Conclusions. Embolotherapy of large PAVMs results in permanent occlusion in an overwhelming majority of patients. Continued patency due to recanalization or accessory artery growth is easily detected and treated.",
author = "Lee, {Daniel W.} and White, {Robert I.} and Egglin, {Thomas K.} and Pollak, {Jeffrey S.} and Fayad, {Pierre B} and Wirth, {Joel A.} and Rosenblatt, {Melvin M.} and Dickey, {Kevin W.} and Burdge, {Catherine M.}",
year = "1997",
month = "10",
day = "1",
doi = "10.1016/S0003-4975(97)00815-1",
language = "English (US)",
volume = "64",
pages = "930--940",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "4",

}

TY - JOUR

T1 - Embolotherapy of large pulmonary arteriovenous malformations

T2 - Long-term results

AU - Lee, Daniel W.

AU - White, Robert I.

AU - Egglin, Thomas K.

AU - Pollak, Jeffrey S.

AU - Fayad, Pierre B

AU - Wirth, Joel A.

AU - Rosenblatt, Melvin M.

AU - Dickey, Kevin W.

AU - Burdge, Catherine M.

PY - 1997/10/1

Y1 - 1997/10/1

N2 - Background. The purpose of this study was to document the long-term results of transcatheter embolotherapy of large pulmonary arteriovenous malformations (PAVMs). Methods. From a data base of 221 consecutive patients with PAVMs treated by embolotherapy between 1978 and 1995, 45 patients with 52 PAVMs, supplied by feeding arteries 8 mm in diameter or larger, were selected for a retrospective investigation. Results. Of 48 patients with 52 large PAVMs, 38 patients (84%) with 44 PAVMs (85%) were cured by the first embolotherapy (mean follow-up, 4.7 years). Acute periprocedural complications included self-limited pleurisy (31%), angina secondary to air embolus (2%), and paradoxical embolization of a device during deployment (4%). None of these events led to short- or long-term sequelae. Seven patients (16%) had persistence of the PAVM attributable to either recanalization (n = 4) or interim accessory artery growth (n = 3). Two of these patients presented with ischemic stroke several years after the initial treatment. Persistent PAVMs (n = 8) were retreated successfully by a second procedure (n = 7), or a third procedure (n = 1) (mean follow-up, 5.9 and 5.3 years, respectively). Conclusions. Embolotherapy of large PAVMs results in permanent occlusion in an overwhelming majority of patients. Continued patency due to recanalization or accessory artery growth is easily detected and treated.

AB - Background. The purpose of this study was to document the long-term results of transcatheter embolotherapy of large pulmonary arteriovenous malformations (PAVMs). Methods. From a data base of 221 consecutive patients with PAVMs treated by embolotherapy between 1978 and 1995, 45 patients with 52 PAVMs, supplied by feeding arteries 8 mm in diameter or larger, were selected for a retrospective investigation. Results. Of 48 patients with 52 large PAVMs, 38 patients (84%) with 44 PAVMs (85%) were cured by the first embolotherapy (mean follow-up, 4.7 years). Acute periprocedural complications included self-limited pleurisy (31%), angina secondary to air embolus (2%), and paradoxical embolization of a device during deployment (4%). None of these events led to short- or long-term sequelae. Seven patients (16%) had persistence of the PAVM attributable to either recanalization (n = 4) or interim accessory artery growth (n = 3). Two of these patients presented with ischemic stroke several years after the initial treatment. Persistent PAVMs (n = 8) were retreated successfully by a second procedure (n = 7), or a third procedure (n = 1) (mean follow-up, 5.9 and 5.3 years, respectively). Conclusions. Embolotherapy of large PAVMs results in permanent occlusion in an overwhelming majority of patients. Continued patency due to recanalization or accessory artery growth is easily detected and treated.

UR - http://www.scopus.com/inward/record.url?scp=0030663612&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030663612&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(97)00815-1

DO - 10.1016/S0003-4975(97)00815-1

M3 - Article

VL - 64

SP - 930

EP - 940

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 4

ER -