Efficacy and Safety of AMPLATZER Vascular Plug Type IV for Embolization of Pulmonary Arteriovenous Malformations

Abstract

Purpose: To assess the efficacy and safety of the AMPLATZER Vascular Plug type IV for pulmonary arteriovenous malformation (PAVM) treatment.

Materials and methods: Between June 2013 and January 2018, 13 patients with 26 PAVMs were treated with the type IV AVP. Patients without follow-up computed tomography (CT) were excluded. Technical success was defined as flow occlusion on angiography. Plug-to-sac distance was measured on angiographic images. Feeding artery and venous sac diameter changes were measured on preprocedural and follow-up CT. Successful embolization was defined as > 70% sac size regression. Procedure time, device migration, and complications were evaluated.

Results: Nine female patients (mean age, 49 y; range, 40-71 y) with 19 PAVMs were enrolled. Four patients with 7 PAVMs were lost to follow-up. Nineteen PAVMs were treated in 11 sessions, and the mean procedure time was 29 min. The technical success rate was 100%. Mean feeding artery diameter was 3.1 mm ± 0.7 (range, 2.1-4.9 mm). Mean plug-to-sac distance was 5.4 mm ± 4.9 (range, 0-13.3 mm). The mean CT follow-up period was 14 months ± 7 (range, 6-30 mo). Sixteen of 19 PAVMs (84%) were successfully embolized. Minor complications (tachycardia and chest discomfort) arose in 2 of 11 sessions. No device migrations or major complications occurred.

Conclusions: The type IV AVP showed an 84% treatment success rate based on 70% sac size regression criteria in small PAVMs. There were no device migrations or major complications.