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OBJECTIVE The purpose of this study was to determine the effects of percutaneous transcatheter coil embolization of pulmonary arteriovenous malformations on arterial oxygen saturation, pulmonary gas exchange, anatomic right-to-left shunt, and lung function and to assess the complications of the procedure. METHODS Fifty-three patients were included in the study: 42 (79%) had associated hereditary hemorrhagic telangiectasia. Nineteen (36%) had neurologic problems compatible with paradoxical embolization. During 102 separate embolization procedures, all malformations with feeding vessels > or = 3 mm in diameter were embolized with steel coils. Arterial oxygen saturation at rest and on exercise and the intrapulmonary right-to-left shunt fraction (99mTc-macroaggregate injection), forced expiratory volume in 1 sec, vital capacity, diffusing capacity for carbon monoxide, and transfer coefficient were measured before and after embolization. Complications of the procedure were recorded and investigated. RESULTS Before treatment, all patients had hypoxemia in the supine posture (SaO2, 89 +/- 1% [standard error of the mean]), which fell a further 6% (absolute) on standing. Mean values for transfer coefficient and diffusing capacity for carbon monoxide were reduced, at 85 +/- 3% and 78 +/- 3% (predicted value), respectively. After embolization, the mean values for supine and erect SaO2 rose to 94 +/- 1% and 93 +/- 1%. Transfer coefficient increased by a mean of 5.4% of predicted value. The mean shunt fraction fell from 23 +/- 2% preembolization to 9 +/- 1% postembolization. In 102 procedures, there were 18 complications, 12 mild, two moderate, and four potentially serious (systemic coil embolization in two patients, cerebrovascular accident [transient], and myocardial puncture), but there were no lasting sequelae. CONCLUSIONS Our results show that coil embolization is an effective and well-tolerated method for treatment of pulmonary arteriovenous malformations. Improvements in pulmonary gas exchange and lung function and a decrease in right-to-left shunting occurred after treatment. The procedure was well tolerated and had a low complication rate.
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
January 1990,
Cor et vasa,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
December 1990,
Cardiovascular and interventional radiology,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
January 1989,
Journal of thoracic imaging,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
December 2004,
Tanisal ve girisimsel radyoloji : Tibbi Goruntuleme ve Girisimsel Radyoloji Dernegi yayin organi,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
March 2006,
Diagnostic and interventional radiology (Ankara, Turkey),
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
November 1998,
AJR. American journal of roentgenology,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
September 2007,
Seminars in interventional radiology,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
January 2002,
Journal of Huazhong University of Science and Technology. Medical sciences = Hua zhong ke ji da xue xue bao. Yi xue Ying De wen ban = Huazhong keji daxue xuebao. Yixue Yingdewen ban,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
October 1993,
Surgical technology international,
J A Dutton, and
J E Jackson, and
J M Hughes, and
M K Whyte, and
A M Peters, and
W Ussov, and
D J Allison
July 1995,
The European respiratory journal,
