Pulmonary arteriovenous fistulas occluded by percutaneous introduction of coil springs

Between July 1980 and July 1983, we occluded 30 pulmonary arteriovenous fistulas (PAVFs) in four patients by percutaneous placement of coil springs. All patients had significant right-to-left shunts and hypoxemia. One presented with recurrent cerebral abscesses following bilateral thoracotomy and lobectomy. The technique requires advancement of the catheter superselectively into the feeding artery just proximal to the fistula. Occlusion at this site preserves the maximum amount of functioning pulmonary parenchyma. Frequently more than one coil spring is required for occlusion. In our experience, the coil spring is a safe, effective, economical vaso-occlusive device for management of PAVFs.