Purpose: The purpose of this study was to evaluate the usefulness of venous sac embolization using J-shaped detachable coils for the transcatheter embolization of pulmonary arteriovenous malformations (PAVM).
Materials and Methods: Six consecutive patients (two men, four women, mean age 53 years, range 27-66 years) with a total of 24 PAVM underwent transcatheter arterial coil embolization. Clinical signs of hereditary hemorrhagic telangiectasia (HTT) were present in 2 patients, while in the others PAVM appeared sporadically. We first framed the venous sac using J-shaped mechanical detachable coils. Then we filled the sac with spiral-shaped detachable mechanical coils. Where necessary we added Nester- and steel coils.
Results: Of the 24 PAVM, 16 were treated with J- and spiral-shaped mechanical detachable coils only. Two minor complications of self-limited chest pain and angina pectoris were observed in two patients. Follow-up CT confirmed the absence of recanalization in 24PAVMs of 6 patients; PAVM addressed by venous sac embolization manifested a decrease of the feeding artery to less than 3mm. None of the patients suffered symptom recurrence during follow-up the ranging from 4 to 21 months.
Conclusion: Venous sac embolization may help to prevent systemic coil migration and facilitate the safe occlusion of large venous sacs. More experience is needed to determine the value of this technique.
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