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Clinical results of transvenous systemic embolotherapy with a neuroradiologic detachable balloon
J S Pollak1, T K Egglin, M M Rosenblatt
1Department of Radiology, Yale University School of Medicine, New Haven, CT 06510.
Purpose:
To evaluate the efficacy of transvenous systemic embolotherapy with a neuroradiologic detachable balloon.
Materials And Methods:
As part of a clinical trial, a detachable silicone balloon was used to occlude pulmonary arteriovenous malformations (PAVMs) in 35 patients and varicocele in 14 patients. In patients with PAVM, the indications for embolotherapy were prophylaxis against paradoxic embolization (n = 35) and dyspnea, fatigue, or both (n = 26); in patients with varicocele, they were pain or a discomforting lesion (n = 8) or infertility (n = 6).
Results:
Balloon embolotherapy was successful in 79 (98%) of the 81 lesions in which it was attempted; 29 (37%) of these 79 balloons were used in conjunction with coils. Ninety-six (97%) of 99 balloons were successfully placed; the three technical failures had no substantial clinical sequelae, and in all three, occlusion was eventually achieved with either detachable balloons or coils. Of six late deflations, five occurred in balloons placed adjacent to coils; only one, which occurred between 1 day and 21 days after placement, resulted in recanalization.
Conclusion:
Transvenous embolization with this detachable balloon was relatively simple and provided cross-sectional occlusion of PAVMs and varicocele.