Hydrogel-coated coils in embolization of pulmonary arteriovenous malformations to prevent recanalization

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K19806
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Nagoya City University
• Principal Investigator: Shimohira Masashi 名古屋市立大学, 大学院医学研究科, 講師 (60597821)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: ハイドロコイル / 肺動静脈奇形 / 塞栓術

Outline of Final Research Achievements

Pulmonary arteriovenous malformations (PAVMs) are abnormal fistulas that appear between the pulmonary arteries and veins that bypass the normal capillaries. Coil embolization is widely performed for PAVMs; however, recanalization of PAVM can be a problem after embolization. To prevent recanalization, the feeding artery of a PAVM should be embolized tightly. The purpose of this study was to evaluate the usefulness of hydrogel-coated coils in preventing recanalization after coil embolization of PAVMs. Thirty-seven consecutive patients with 57 untreated PAVMs underwent coil embolization with hydrogel-coated coils. In 56 of 57 PAVMs, embolization was successfully performed with hydrogel-coated coils. There was no recanalization with a mean follow-up period of 19 months in 56 PAVMs embolized with hydrogelcoated coils. There were no major complications. Hydrogel-coated coils may be useful for preventing recanalization after the embolization of PAVMs.

Free Research Field

放射線医学

Academic Significance and Societal Importance of the Research Achievements

肺動静脈奇形は、肺動脈と肺静脈の異常な右左短絡である。慢性低酸素血症により、労作性呼吸困難やチアノーゼなどの症状のほか、静脈血内の血栓や細菌が、肺の毛細血管にトラップされず左心系に流れ、脳梗塞や脳膿瘍という重篤な中枢神経系合併症を引き起こす。このため、無症候性であっても治療適応となり、コイル塞栓術が現在第一選択の治療法であるが術後の再開通が大きな問題点であった。本研究ではハイドロコイルを使用することにより術後の再開通率を減少させることを明らかにした。これにより肺動静脈奇形を有する患者は再治療を受ける必要がなくなり、患者の負担軽減および医療経済に貢献できる結果と考える。