Embolotherapy of pulmonary arteriovenous malformations with detachable balloons: Long-term durability and efficacy

PURPOSE: To determine long-term durability and efficacy of pulmonary arteri ovenous malformation (PAVM) embolotherapy using detachable gold valve latex (GVB) and silicone balloons (DSB). MATERIALS AND METHODS: Eighty-two patients were treated with either GVBs or DSBs between 1991 and 1996, Complete followup, consisting of chest radiogr aphy or high-resolution chest computed tomography, was obtained in each pat ient between 1996 and 1998, The PAVM was considered cured if the aneurysmal portion was involuted with or without a small residual scar. RESULTS: Eighty-two of the 85 DSBs (96%) were inflated 2-4 years later, and none of the 56 GVBs remained inflated 1-3 years after placement, Despite e arly deflation of the GVB (91% at 1 month), only one PAVM persisted in both groups (DSB and GVB), Clinical and radiographic involution of the PAVMs wa s complete in all patients except one, who was easily re-treated, No migrat ion of DSBs or GVBs to the systemic circulation occurred. CONCLUSIONS: DSBs and GVBs provide immediate cross-sectional occlusion of P AVM and are equally effective in "curing" the PAVM, The DSBs remain inflate d 2-4 years after placement provided isoosmotic contrast material is used t o inflate them and volume recommendations are adhered to, No early or late migration of the DSB or GVB occurs, provided they are securely placed.