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Abstract No. 663 Greater shrinkage of the draining vein of pulmonary arteriovenous malformations after venous sac and feeding artery embolization than after feeding artery embolization alone

2020; Elsevier BV; Volume: 31; Issue: 3 Linguagem: Inglês

10.1016/j.jvir.2019.12.724

1535-7732

Keisuke Nagai, Keigo Osuga, Eiji Kashiwagi, Shinya Kosai, Hidenari Hongyo, Kaishu Tanaka, Yusuke Ono, Hiroki Higashihara, Noriyuki Tomiyama,

Pulmonary Hypertension Research and Treatments

The purpose of this study was to investigate the difference in the shrinkage rates of the draining vein between feeding artery embolization (FAE) and venous sac and feeding artery embolization (VFE) for pulmonary arteriovenous malformations (PAVMs). Between August 2005 and December 2018, 26 patients (M:F = 7:19; mean age, 51.0 y) with 42 PAVMs underwent successful coil embolization defined by complete blood flow cessation of each PAVM on DSA. Twenty PAVMs were treated with FAE (FAE group), while 22 PAVMs were treated with VFE (VFE group). The posttreatment CT images obtained after 8-20 months were used for outcome analysis. The baseline diameters (mm) of feeding artery (FA), venous sac (VS), draining vein (DV), and posttreatment DV diameter (mm) were measured on thin-section CT images (slice thickness 0.5-0.625 mm) in the lung-window setting. FA diameter was measured just proximal to VS. VS was measured in the maximum short-axis diameter. The posttreatment DV diameter was measured just distal to VS. The pretreatment DV diameter was defined as the same point as the posttreatment DV diameter. The average shrinkage rates of DV were compared between the two groups. Patient background (age, sex, rate of HHT, lesion locations) were comparable between the two groups. Follow-up periods (days) were 388.3 ± 90.8 (range, 267-560) and 404.7 ± 104.2 (range, 258-587) in the FAE group and the VFE group, respectively (P = 0.781). The baseline FA, VS, DV, and posttreatment DV diameters (mm) were 2.87 ± 1.31 (range, 1.4-7.9) and 3.21 ± 1.04 (range, 1.5-5.8) (P = 0.126), 7.41 ± 4.10 (range, 2.7-22.9) and 7.25 ± 2.97 (range, 2.0-13.4) (P = 0.801), 3.08 ± 0.99 (range, 1.9-5.4) and 3.70 ± 1.12 (range, 1.4-5.8) (P = 0.052), and 1.64 ± 0.60 (range, 0.7-3.0) and 1.35 ± 0.66 (range, 0.7-3.4) (P = 0.073), respectively. The shrinkage rates of DV in the FAE group and the VFE group were 43.1 ± 23.6 (range, 0.0-76.7) % and 62.2 ± 15.6 (range, 22.7-82.8) %, respectively, with a significant difference (P = 0.009). Greater shrinkage rate of the draining vein in the VFE group suggests that persistence of PAVM is less likely when treated with VFE than with FAE.