Percutaneous femoral venous catheterizations: A prospective study of complications

Abstract

To evaluate the safety and effectiveness of Amplatzer vascular plugs (AVPs) for percutaneous closure of arteries feeding pulmonary arteriovenous malformations (PAVMs).Over a 45-month period, 24 consecutive patients with at least one PAVM treated with an AVP were selected from a database on patients with a PAVM who received embolotherapy. Immediate technical success was defined as the complete absence of flow through the PAVM after embolization without the need for additional embolization material. Success on follow-up imaging was defined as a reduction in size of at least 70% of the aneurysm or draining vein on follow-up computed tomography or the absence of flow through the PAVM on a subsequent pulmonary angiogram.Thirty-seven AVPs were used to close 36 feeding arteries in 35 PAVMs in seven male and 17 female patients aged 11–86 years (mean age, 50 y). Technical success was achieved in 35 feeding arteries (97%). One feeding artery required two AVPs for closure. There were no immediate procedure-related complications. At a mean clinical follow-up of 322 days (range, 1–1,126 d), all patients were alive without new PAVM-related complications. Imaging follow-up was available for 29 embolized vessels (81%) with a mean follow-up of 418 days (range, 40–937 d), and recanalization occurred in two treated vessels (7%).AVPs are safe and effective for closure of PAVMs feeding vessels that can be reached with a guiding catheter, with an acceptable rate of recanalization.