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CardioVascular and Interventional Radiology

, Volume 39, Issue 8, pp 1110–1114 | Cite as

Amplatzer Vascular Plugs Versus Coils for Embolization of Pulmonary Arteriovenous Malformations in Patients with Hereditary Hemorrhagic Telangiectasia

  • Noam Tau
  • Eliyahu Atar
  • Meir Mei-Zahav
  • Gil N. Bachar
  • Tamir Dagan
  • Einat Birk
  • Elchanan Bruckheimer
Clinical Investigation

Abstract

Purpose

Coil embolization of pulmonary arteriovenous malformations (PAVMs) has a high re-canalization/re-perfusion rate. Embolization with Amplatzer plugs has been previously described, but the long-term efficacy is not established. This study reports the experience of a referral medical center with the use of coils and Amplatzer plugs for treating PAVMs in patients with hereditary hemorrhagic telangiectasia.

Methods

The study was approved by the Institutional Review Board with waiver of informed consent. The cohort included all patients who underwent PAVM embolization in 2004–2014 for whom follow-up imaging scans were available. The medical files were retrospectively reviewed for background data, embolization method (coils, Amplatzer plugs, both), and complications. Re-canalization of treated PAVMs was assessed from intrapulmonary angiograms (following percutaneous procedures) or computed tomography angiograms. Fisher’s exact test and Pearson Chi-squared test or t test were used for statistical analysis, with significance at p < 0.05.

Results

16 patients met the study criteria. Imaging scans were available for 63 of the total 110 PAVMs treated in 41 procedures. Coils were used for embolization in 37 PAVMs, Amplatzer plugs in 21, and both in five. Median follow-up time was 7.7 years (range 1.4–18.9). Re-canalization was detected in seven vessels, all treated with coils; there were no cases of re-canalization in plug-occluded vessels (p = 0.0413).

Conclusion

The use of Amplatzer plugs for the embolization of PAVMs in patients with hemorrhagic telangiectasia is associated with a significantly lower rate of re-canalization of feeding vessels than coils. Long-term prospective studies are required to confirm these findings.

Keywords

Amplatzer Plugs Coils HHT Hereditary hemorrhagic telangiectasia OWR Osler–Weber–Rendu Re-canalization Embolization PAVM Pulmonary AVM 

Notes

Compliance with Ethical Standards

Conflict of interest

All other authors declare that they have no conflicts of interest.

Informed Consent

The study was approved by the Institutional Review Board with waiver of informed consent.

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Copyright information

© Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2016

Authors and Affiliations

  • Noam Tau
    • 1
    • 4
  • Eliyahu Atar
    • 1
    • 4
  • Meir Mei-Zahav
    • 2
    • 4
  • Gil N. Bachar
    • 1
    • 4
  • Tamir Dagan
    • 3
    • 4
  • Einat Birk
    • 3
    • 4
  • Elchanan Bruckheimer
    • 3
    • 4
  1. 1.Department of Diagnostic ImagingRabin Medical Center – Beilinson and HaSharon CampusesPetach TikvaIsrael
  2. 2.Department of Pulmonology and National HHT CenterSchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  3. 3.Institute of Pediatric CardiologySchneider Children’s Medical Center of IsraelPetach TikvaIsrael
  4. 4.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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