REGULAR CONTENT
Final ID
590
Type
Educational Exhibit-Poster Only
Authors
B Andring1, P Sutphin1, M Chamarthy1, M Anderson1, K Singh1, H Park1, S Kalva1
Institutions
1University of Texas Southwestern Medical Center, Dallas, TX
Purpose
• Review the anatomy, types, and methods of diagnosis of pulmonary arteriovenous malformations (PAVMs) • Review the indications and contraindications of PAVM embolization.• Demonstrate the techniques of PAVM embolization using coils, nitinol vascular plugs, PTFE coated nitinol plugs or combination of these with numerous case examples from our extensive institutional experience.• Briefly review the outcomes of PAVM embolization.
Materials & Methods
PAVMs can either occur sporadically (30%) or as a part of an autosomal dominant genetic disorder, hereditary hemorrhagic telangiectasia (70%). AVMs can be simple or complex with optimal visualization of all feeding arteries essential for complete embolization. Although large AVMs can cause cardiopulmonary symptoms from shunting, the primary indication for embolization is the prevention of paradoxical emboli. The tendency for progressive enlargement of native AVMs, 20% recanalization rates, and the possibility of new AVMs to develop after neighboring AVM embolization, make follow up of these patients essential.
Results
Technological advances in imaging, catheters, and embolization materials have refined the procedure and challenged the '3 mm guideline'. We will focus on these novel materials and techniques that will assist the interventional radiologist. This will include a demonstration of catheters optimally designed to access the pulmonary artery and to select increasingly smaller caliber feeding arteries. Additional emphasis will be placed on a variety of embolic coils and plugs including when and how to deploy such devices and common pitfalls to avoid. We will highlight the unique considerations of working in the pulmonary arterial system including the use of anticoagulation and the prevention of iatrogenic air embolism. We will also briefly review the results of PAVM embolization using various different embolic materials.
Conclusions
PAVM embolization is often performed at tertiary care centers and, therefore, may be unfamiliar to many practicing interventional radiologists. We highlight unique considerations when performing this procedure and provide an overview of the recent advances in materials and methods that our institution has adopted.
Final ID
590
Type
Educational Exhibit-Poster Only
Authors
B Andring1, P Sutphin1, M Chamarthy1, M Anderson1, K Singh1, H Park1, S Kalva1
Institutions
1University of Texas Southwestern Medical Center, Dallas, TX
Purpose
• Review the anatomy, types, and methods of diagnosis of pulmonary arteriovenous malformations (PAVMs) • Review the indications and contraindications of PAVM embolization.• Demonstrate the techniques of PAVM embolization using coils, nitinol vascular plugs, PTFE coated nitinol plugs or combination of these with numerous case examples from our extensive institutional experience.• Briefly review the outcomes of PAVM embolization.
Materials & Methods
PAVMs can either occur sporadically (30%) or as a part of an autosomal dominant genetic disorder, hereditary hemorrhagic telangiectasia (70%). AVMs can be simple or complex with optimal visualization of all feeding arteries essential for complete embolization. Although large AVMs can cause cardiopulmonary symptoms from shunting, the primary indication for embolization is the prevention of paradoxical emboli. The tendency for progressive enlargement of native AVMs, 20% recanalization rates, and the possibility of new AVMs to develop after neighboring AVM embolization, make follow up of these patients essential.
Results
Technological advances in imaging, catheters, and embolization materials have refined the procedure and challenged the '3 mm guideline'. We will focus on these novel materials and techniques that will assist the interventional radiologist. This will include a demonstration of catheters optimally designed to access the pulmonary artery and to select increasingly smaller caliber feeding arteries. Additional emphasis will be placed on a variety of embolic coils and plugs including when and how to deploy such devices and common pitfalls to avoid. We will highlight the unique considerations of working in the pulmonary arterial system including the use of anticoagulation and the prevention of iatrogenic air embolism. We will also briefly review the results of PAVM embolization using various different embolic materials.
Conclusions
PAVM embolization is often performed at tertiary care centers and, therefore, may be unfamiliar to many practicing interventional radiologists. We highlight unique considerations when performing this procedure and provide an overview of the recent advances in materials and methods that our institution has adopted.