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Published on: October 20, 2017
Initial experience with use of hydrogel microcoils in embolization of pulmonary arteriovenous malformations
Keigo Osuga1, Kentaro Kishimoto1, Kaishu Tanaka1
1Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871 Japan.
Abstract:
The purpose of this study is to describe our initial experience with embolization of pulmonary arteriovenous malformations (PAVMs) using hydrogel microcoils. The technical and radiological outcomes were retrospectively reviewed in seven patients with nine simple-type PAVMs (median feeder size 4 mm, range 3-6 mm) who underwent embolization. Hydrogel microcoils were mainly used, and detachable bare microcoils were combined as needed to occlude the terminal feeding artery just before the sac. Of a total of 43 microcoils, 30 (69.8%) hydrogel microcoils were deployed in eight PAVMs with the median number 3.5 (range 2 to 6) per lesion. All hydrogel microcoils were successfully deployed without microcatheter stuck or malposition. In the remaining one small PAVM, only soft bare microcoils were used, however, resulting in recanalization requiring additional coils in the second session. The venous sac was substantially shrunk in all lesions treated with hydrogel microcoils with the median size reduction rate 95.0% (range 81.8% to 99.0%) during the median follow-up period 10 months (range 6 to 18 months). In conclusion, hydrogel microcoils were safely and effectively applied for occluding PAVMs with relatively small feeders.
Insights
Hydrogel microcoils offer a safe and effective method for embolizing pulmonary arteriovenous malformations (PAVMs). This study shows significant shrinkage of PAVMs treated with these innovative coils.
Area of Science:
- Interventional Radiology
- Vascular Medicine
- Medical Device Technology
Background:
- Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary arteries and veins.
- Embolization is a common treatment for PAVMs, but coil selection can impact outcomes.
- Hydrogel microcoils represent a newer option for PAVM embolization.
Purpose of the Study:
- To evaluate the initial clinical experience with hydrogel microcoils for PAVM embolization.
- To assess the technical and radiological outcomes of using hydrogel microcoils in patients with PAVMs.
Main Methods:
- Retrospective review of seven patients with nine simple-type PAVMs.
- Embolization performed using primarily hydrogel microcoils, supplemented with detachable bare microcoils.
- Analysis of coil deployment success, complications, and PAVM size reduction post-treatment.
Main Results:
- Hydrogel microcoils were successfully deployed in 8/9 PAVMs without complications.
- A significant median size reduction of 95.0% was observed in PAVMs treated with hydrogel microcoils.
- One PAVM treated solely with bare microcoils showed recanalization, requiring a second procedure.
Conclusions:
- Hydrogel microcoils are safe and effective for embolizing PAVMs, particularly those with smaller feeding arteries.
- Successful deployment and substantial PAVM shrinkage were achieved using hydrogel microcoils.
- Hydrogel microcoils demonstrate promising results as an alternative embolic agent for PAVMs.
