Ahmed Kamel Abdel Aal MBBCh, Abstract Co-Author: Consultant, AGA Medical Corporation

Souheil Saddekni MD, Abstract Co-Author: Nothing to Disclose

Sherif Osman MD, Abstract Co-Author: Nothing to Disclose

Maysoon Farouk Hamed MD, MSC, Abstract Co-Author: Nothing to Disclose

Rachel Fineberg Oser MD, Abstract Co-Author: Nothing to Disclose

Edgar S. Underwood MD, Abstract Co-Author: Nothing to Disclose

Peyman Borghei MD, Presenter: Nothing to Disclose

The occlusion time of embolic devices determines the potential for embolic complications caused by small loose clots that can be formed over the surface of these devices and break away.This is important in PAVMS where there is right to left shunt.The purpose of our study is to determine the occlusion time and the number of Amplatzer vascular plug II(AVP II)devices used in transcatheter embolization of PAVMs.This will help determine the safety of this embolic device in treatment of these lesions.  

We treated 20 PAVMs in 5 patients using AVP II.We treated 4 females and one male patient. Patient age ranged from 24 to 60 years (average 42 years).Patients presented dyspnea,stroke,aphasia and hemiplegia.All our patients were diagnosed with PAVMs based on prior CT angiography.We recorded the number of PAVMs in each patient,their location,type,diameter and number of feeding arteries,number and size of the AVP II devices used,and the occlusion time.We also reviewed the coagulation profile of our patients that was done at the time of the procedure.  

All of our patients had multiple PAVMs.The feeding artery diameters ranged from 3.2 to 9.4 mm.Nine(45%)of the PAVMs were distributed in the right lower lobe segments,7(35%)in the left lower lobe segments,3(15%) in the right middle lobe segments and 1(5%)in the left upper lobe.All of our patients had simple PAVMs with a single feeding artery.Complete occlusion was achieved in each PAVM with deployment of a single AVP II device.The size of the AVP devices used ranged from 6 mm to 12 mm. The occlusion times for AVP II device ranged from 66 seconds to 235 seconds with an average time of 120 seconds(two minutes). The INR was within normal range for all patients and ranged from 0.98 to 1.09.We found weak positive correlation between the diameter of the feeding artery and the determined occlusion times with a correlation coefficient measuring about 0.19441.We found weak negative correlation between the INR value and the determined occlusion times with a correlation coefficient measuring about -0.27264.

The short occlusion time of the AVP II determined in our study,and the need to place only one device for each feeding artery makes it a safe device for treatment of PAVMs with no increased risk of systemic embolization.

The short occlusion time of Amplatzer vascular plug II devices makes them safe for treatment of PAVMs

Abdel Aal, A, Saddekni, S, Osman, S, Hamed, M, Oser, R, Underwood, E, Borghei, P, Calculating the Occlusion Time for Amplatzer Vascular Plug II Used in Treatment of Pulmonary Arteriovenous Malformations Helps Determine Its Safety.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006247.html