Thomas W. Schlosser MD, Presenter: Nothing to Disclose

Mykhaylo Burbelko, Abstract Co-Author: Nothing to Disclose

Matthias Ulrich, Abstract Co-Author: Nothing to Disclose

Gerald Antoch MD, Abstract Co-Author: Nothing to Disclose

Ralf Adamus MD, Abstract Co-Author: Nothing to Disclose

The aim of this study was to evaluate the technical feasibility and safety of a new interventional-radiological technique to create a shunt between the external iliac vein and artery in patients with severe COPD. The creation of this fistula aims improving pulmonary oxygenation, reducing systemic vascular resistance and increasing cardiac output in these patients.

Thirty-seven patients were included in this multicenter trial. All patients underwent CT angiography with image reconstruction in the coronal plane to evaluate the pelvic vessels before the intervention. Two patients had to be excluded from the study based on either too large distance between the iliac vessels on both sides or based on severe calcifications of the iliac arteries, respectively. In 35 patients the artery was punctured from the vein with a novel crossing needle. Using a special delivery system a novel nitinol device (anastomotic coupling system, ROX medical) was implanted between the artery and vein to maintain a fistula between both vessels. All shunts were dilated with a 4mm balloon and documented by DSA.

Shunt implantation was successful in all 35 patients. The perfused arterio-venous shunts could be well documented in DSA and the diameter was measured between 3 and 4 mm in all cases. Peri-interventional dissection of the iliac artery occurred in one patient. This dissection was not flow limiting. Post-interventional venous bleeding in one patient was treated successfully by local compression.

The new interventional – radiological technique to create an arteriovenous shunt in the iliac vessels presented in this study has proven to be feasible and safe. The intended improvement of pulmonary oxygenation to reduce dyspnoe in patients with severe COPD has to be evaluated.

The new interventional – radiological technique to create an arteriovenous shunt in the iliac vessels presented in this study has proven to be feasible and safe.

Schlosser, T, Burbelko, M, Ulrich, M, Antoch, G, Adamus, R, Percutaneous Arteriovenous Shunting in Patients with Severe COPD: A Novel Interventional Treatment.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11012157.html