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CardioVascular and Interventional Radiology

, Volume 29, Issue 1, pp 70–74 | Cite as

Clinical and Radiological Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations

  • Poul Erik AndersenEmail author
  • Anette D. Kjeldsen
CLINICAL INVESTIGATION

Abstract

The purpose was to evaluate the clinical and radiological long-term results of embolization of pulmonary arteriovenous malformations (PAVMs) and to assess the quality of life after treatment. A clinical follow-up was undertaken after 67 months (mean) in 35 consecutive patients with 106 PAVMs. Outcome parameters at follow-up were PaO2 and patients’ satisfaction. During follow-up, the patients had a clinical examination, measurement of arterial blood gases, chest X-ray, and contrast echocardiography performed and were asked to fill in a questionnaire exploring experience of the treatment and subjective effect of treatment on physical and social functioning. A significant rise in oxygenation of the blood after embolization was measured. In 77% of the patients symptoms improved, and 71% felt better performance. In eight patients, one of the PAVMs was found insufficiently embolized or recanalized at follow-up angiography and therefore were re-embolized. Endovascular embolization for PAVMs is effective. Clinical parameters and quality of life improved significantly. Regular clinical controls after therapy are necessary to discover insufficiently embolized, recanalized or new PAVMs.

Keywords

Interventional radiology Arteriovenous fistula Arteriovenous malformations Embolization, Therapeutic Lung diseases Pulmonary artery Pulmonary circulation 

References

  1. 1.
    Wirth JA, Pollak JS, White RI Jr (1996) Pulmonary Arteriovenous Malformations. Current Pulmonology and Critical Care Medicine Vol. 17. Mosby-Year Book. St. Louis, MOGoogle Scholar
  2. 2.
    White RI Jr, Lynch-Nyhan A, Terry P, et al. (1988) Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology 169:663–669PubMedGoogle Scholar
  3. 3.
    Porstmann W (1997) Therapeutic embolization of arteriovenous pulmonary fistula by catheter technique. In: Kelop O (ed) Current Concepts In Pediatric Radiology. Springer-Verlag. Berlin, pp 23–31Google Scholar
  4. 4.
    Lee DW, White RI Jr, Egglin TK, et al. (1997) Embolotherapy of large pulmonary arteriovenous malformations: long-term results. Ann Thorac Surg 64:930–940PubMedGoogle Scholar
  5. 5.
    Sagara K, Miyazono N, Inoue H, et al. (1998) Recanalization after coil embolotherapy of pulmonary arteriovenous malformations: study of long-term outcome and mechanism for recanalization. Am J Roentgenol 170:727–730Google Scholar
  6. 6.
    Mager JJ, Overtoom TTC, Blauw H, et al. (2004) Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients. J Vasc Intervent Radiol 15:451–456Google Scholar
  7. 7.
    Haitjema T, Overtoom TTC, Westermann CJJ, et al. (1995) Embolisation of pulmonary arteriovenous malformations: results and follow-up in 32 patients. Thorax 50:719–723PubMedGoogle Scholar
  8. 8.
    White RI Jr, Pollak JS, Wirth JA (1996) Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy. J Vasc Intervent Radiol 7:787–804Google Scholar
  9. 9.
    Andersen PE, Kjeldsen AD, Oxhøj H, et al. (1999) Percutaneous transluminal treatment of pulmonary arteriovenous malformations. J Intervent Radiol 14:164–170Google Scholar
  10. 10.
    Iqbal M, Rossoff LJ, Steinberg HN, et al. (2000) Pulmonary arteriovenous malformations: a clinical review. Postgrad J Med 76:390–394Google Scholar
  11. 11.
    White RI Jr, Mitchell SE, Barth KH, et al. (1983) Angioarchitecture of pulmonary arteriovenous malformations: an important consideration before embolotherapy. Am J Roentgenol 140:681–686Google Scholar
  12. 12.
    Andersen PE, Kjeldesen AD, Oxhøj H, et al. (1998) Embolotherapy for pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber Syndrome). Acta Radiol 39:723–726PubMedGoogle Scholar
  13. 13.
    Kjeldsen AD, Oxhøj H, Andersen PE, et al. (1999) Pulmonary arteriovenous malformations. Screening procedures and pulmonary angiography in patients with hereditary hemorrhagic telangiectasia. Chest 116:432–439CrossRefPubMedGoogle Scholar
  14. 14.
    Kjeldsen AD, Oxhøj H, Andersen PE, et al. (2000) Prevalence of pulmonary arteriovenous malformations (PAVMs) and occurrence of neurological symptoms in patients with hereditary haemorrhagic telangiectasia (HHT). J Intern Med 248:255–262CrossRefPubMedGoogle Scholar
  15. 15.
    Gossage JR, Kanj G (1998) Pulmonary arteriovenous malformations. A state of the art review. Am Rev Respir Crit Med 58:643–661Google Scholar
  16. 16.
    Remy-Jardin M, Wattinne L, Remy J (1991) Transcatheter occlusion of pulmonary arterial circulation and collateral supply: failures, incidents, and complications. Radiology 180;699–705PubMedGoogle Scholar
  17. 17.
    Lacombe P, Lagrange C, Hajjam ME, et al. (2005) Reperfusion of complex pulmonary arteriovenous malformations after embolization: report of three cases. Cardiovasc Intervent Radiol 28:30–35CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  1. 1.Department of RadiologyOdense University HospitalOdense CDenmark
  2. 2.Department of OtorhinolaryngologyOdense University HospitalOdense CDenmark

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