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A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment

100%

Masiello R., Iadevaia C., Grella E., Tranfa C., Cerqua F., Rossi G., Santoro G., Amato B., Rocca A., De Dona R., Lavoretano S., Perrotta F.

Open Medicine

2014

vol. 10

issue 1

Pulmonary arteriovenous Malformations (PAVMs) are a rare vascular alteration characterized by abnormal communications between the pulmonary arteries and veins resulting in an extracardiac right-to-left (R-L) shunt. The majority of PAVMs are associated with an autosomal dominant vascular disorder also known as Osler-Weber- Rendu Syndrome. PAVMs appearance can be both single and multiple. Clinical manifestations include hypoxemia, dyspnea cyanosis, hemoptysis and cerebrovascular ischemic events or abscesses. We report a case of an 18 year old female with severe respiratory failure caused by a relapse of multiple unilateral pulmonary arterovenous fistula. Symptoms at admission include dyspnea, cyanosis and clubbing. The patient underwent pulmonary angio-TC scan, brain CT and echocardiography. The thoracic angio-CT scan showed the presence of PAVMs of RUL and RLL; a marked increase of right bronchial artery caliber and its branches with an aneurismatic dilatation was also observed. The patient underwent percutaneous transcatheter embolization using Amplatzer Vascular Plug IV; a relevant clinical and functional improvement was subsequently recorded. Embolization is effective in the treatment of relapsing PAVMS.

"Imageable" Zinc-Silicate Glass Microspheres For Transarterial Embolization: A Renal Artery Embolization Study.

75%

Kehoe S., Amensag S., Looney M., Abraham R. J., Boyd D.

vol. 1

issue 1

Intrinsically radiopaque (imageable) microspheres for transarterial embolization (TAE) are required to enable real-time intraprocedural feedback and definition of spatial distribution patterns of embolic materials in target tissues. This pilot study evaluates acute and sub-chronic safety and efficacy of imageable zinc-silicate (Zn-Si) glass microspheres in a swine renal artery embolization (RAE) model. Eight swine were divided into two cohorts. Clinical determinants of embolization effectiveness, including imageability, deliverability and temporal/ spatial distribution of microspheres in target tissues were assessed. Subsequently, cohort I and II were used to evaluate the acute and subchronic host response against the Zn-Si microspheres versus a clinical control. The developed microspheres provide for direct intraprocedural feedback using standard diagnostic imaging techniques. Fluoroscopy correlated with ex-vivo high-resolution radiography, CT and micro-CT, demonstrating high imageability, excellent spatial distribution and packing of the Zn- Si microspheres. At follow-up, infarction of the embolized kidneys was noted without any major adverse tissue reaction. Mild recanalization was observed microscopically for both experimental and control microspheres. Zn-Si microspheres permit the definition of spatial distribution in a target tissue, consequently permitting the optimization, personalization and improvement of TAE techniques.

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1 Biomedical glasses

1 Open Medicine

2 2015

1 Abraham R. J.

1 Amato B.

1 Amensag S.

1 Boyd D.

1 Cerqua F.

1 De Dona R.

1 Grella E.

1 Iadevaia C.

1 Kehoe S.

1 Lavoretano S.

1 Looney M.

1 Masiello R.

1 Perrotta F.

1 Rocca A.

1 Rossi G.

1 Santoro G.

1 Tranfa C.

Search results

A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment

"Imageable" Zinc-Silicate Glass Microspheres For Transarterial Embolization: A Renal Artery Embolization Study.