A modified metallic coil embolization technique for pulmonary arteriovenous malformations using coil anchors and occlusion balloon catheters.

PURPOSE: To evaluate the feasibility and efficacy of a modified metallic coil embolization technique for pulmonary arteriovenous malformations (PAVMs) using coil anchors and occlusion balloon catheters.

METHODS

Five consecutive female patients with 6 PAVMs were included in the present study. One of the 6 PAVMs was of the complex type with four feeding arteries. An occlusion balloon catheter was inserted into the feeding artery as close to the venous sac as possible. The coil anchor, which was a simple W-shaped bent stainless steel wire with two markers at each end, was deployed prior to embolization to prevent the systemic migration of embolic materials. Then, metallic coils were deployed around the coil anchors under inflow stoppage using the inflated occlusion balloon catheter. In the complex-type PAVM, the main feeder was occluded by this technique and the other three small feeders were embolized with metallic coils only.

RESULTS

In all 5 cases, occlusion balloon catheters could be inserted into the feeding arteries just proximal to the venous sacs, coil anchors were easily deployed, and complete occlusion was achieved without any migration of metallic coils or paradoxical embolism during the procedure.

CONCLUSIONS

The modified metallic coil embolization technique with coil anchors and occlusion balloon catheters was feasible and considered to be useful in preventing procedure-related complications.