Coil Embolization for Pulmonary Arteriovenous Malformation as an Organ-sparing Therapy: Outcome of Long-term Follow-up

Purpose: Pulmonary artery coil embolization (PACE) is increasingly utilized to treat pulmonary arteriovenous malformations (PAVMs), but the long-term outcome of this treatment modality remains unclear. By evaluating the long-term outcome of patients at St. Marianna University Hospital treated with PACE, we wanted to see if PACE could effectively replace the surgical resection of PAVMs. Patients and Methods: We retrospectively evaluated 9 consecutive patients (4 males, 5 females; age range, 16-67 years; mean +/- SD, 43.6 +/- 18.7 years) who underwent PACE for PAVMs. Selective pulmonary artery angiography using Seldinger's method was initially performed to identify the feeding arteries. This was followed by embolization using interlocking detachable coils and microcoils. Results: The procedure resulted in no severe complications. All treated patients were free from PAVM symptoms. A recurrence did not occur after PACE in 8 of 9 (88%) patients for 31 to 173 months (86 +/- 51). Recanalization of the embolized malformation occurred after 3 months in one patient. This patient underwent an additional successful PACE without any further recurrences for 73 months. Conclusions: PACE is an organ-sparing therapy with satisfactory long-term results. It can safely replace the surgical resection of PAVMs.