Embolization Outcomes of Pulmonary Arteriovenous Malformations: A 10-Year Experience from a Tertiary Referral Center

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Purpose: To determine clinical outcomes of embolization of pulmonary arteriovenous malformation (PAVM) using different embolization techniques and establish recanalization rate in a tertiary referral center Materials and Methods: Consecutive patients with PAVM who underwent embolization from 2011 to 2021 were identified and retrospectively analyzed. The primary end-points of the study were the efficacy of the embolotherapy and persistence of PAVM on follow-up imaging. Secondary end-point was incidence of complications. Results: 41 patients (25 (61%) HHT positive) with 212 PAVMs were included (28 female, mean age 47 ± 12 years, range 19–76 years). 187 PAVMs were simple and 15 were complex in angioarchitecture. 100 PAVMs were treated. The mean feeding artery diameter was 5 ±2 mm and the draining vein diameter was 6 ± 2 mm. Mean sac diameter was 27 ±10 mm. Mean follow-up was 25 ± 10 months. The technical success rate for all embolotherapy was 97% and treatment success was 98%. 35 Amplatzer vascular plugs (AVPs), 48 microvascular plugs (MVP) and 69 coils were deployed. 6 patients had AVP and coils and 6 patients had MVP and coils. Technical success rate for AVP was 92%, coils 85% and MVP 100%. Treatment success for AVP was 90%, coils 80% and MVP 100%. Recanalization rate was 8%. Recanalization rate post-AVP was 3%, coils 4% and 1% post-MVP. 2 (4%) patients developed pleuritic chest pain post procedure and there was one coil migration. Conclusion: Embolotherapy for PAVMs is safe and effective. MVPs were associated with superior clinical outcomes compared with AVPs and coils. Publication History Article published online: 02 April 2024 © 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Georg Thieme Verlag KG Stuttgart · New York

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