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Reperfusion of Pulmonary Arteriovenous Malformations Following Embolotherapy: A Randomized Controlled Trial of Detachable Versus Pushable Coils

  • Clinical Investigation
  • Embolisation (arterial)
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To compare 1 year post-embolization reperfusion rates in pulmonary arteriovenous malformations (PAVMs) treated with the 0.035″ Interlock™ Fibered IDC™ Occlusion System coils (IDC) (Boston Scientific, Marlborough, Massachusetts) versus 0.035″ Nester coils (Cook Medical Inc., Bloomington, Indiana).

Materials and Methods

A randomized controlled trial was performed randomizing individual PAVMs to treatment with IDC versus Nester coils at the largest hereditary hemorrhagic telangiectasia center in Canada. The primary outcome was CT evidence of reperfusion at 1 year. Secondary outcomes included periprocedural complications, fluoroscopy time and contrast volume.

Results

Our study was terminated prematurely due to slow recruitment and subsequent expiration of funding. A total of 46 PAVMs in 25 patients (64% female) were included in our study; 26 randomized to Nester coils and 20 randomized to IDC. One patient was lost to follow-up. At a mean follow-up of 421.2 ± 215.7 days, no significant difference in PAVM reperfusion was detected between Nester coils and IDC (0% vs. 5.6%, p > 0.05). No major periprocedural complications were noted in either group. Fluoroscopy time (Nester: 15.0 ± 11.8 min vs. IDC 16.0 ± 5.4 min, p > 0.05) and contrast volume (Nester: 80.3 ± 36.5 ml vs. IDC 87.3 ± 51.7 ml, p > 0.05) utilized did not differ between groups.

Conclusion

No significant difference was detected in PAVM reperfusion rates, periprocedural complication rates, contrast volume utilization or fluoroscopy time following embolization with IDC and Nester coils.

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Acknowledgements

We would like to acknowledge Boston Scientific (Marlborough, Massachusetts) who provided research grant funding for this study.

Funding

This study was funded by a research grant provided by Boston Scientific Corporation which provided coil material for embolization. Boston Scientific was not involved in data collection, analysis, data interpretation or manuscript writing.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, St. Michael’s Hospital, University of Toronto, Toronto, Canada

    Sean A. Kennedy & Vikramaditya Prabhudesai

  2. Li Ka Shing Knowledge Institute, Toronto, Canada

    Sean A. Kennedy, Marie E. Faughnan, Nicholas T. Vozoris & Vikramaditya Prabhudesai

  3. Toronto HHT Centre, St. Michael’s Hospital, Toronto, Canada

    Marie E. Faughnan & Nicholas T. Vozoris

  4. Division of Respirology, Department of Medicine, University of Toronto, Toronto, Canada

    Marie E. Faughnan & Nicholas T. Vozoris

Authors
  1. Sean A. Kennedy
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  2. Marie E. Faughnan
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  3. Nicholas T. Vozoris
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  4. Vikramaditya Prabhudesai
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Corresponding author

Correspondence to Sean A. Kennedy.

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Conflict of interest

VP has received a research grant from Boston Scientific Corporation. SAK, MEF and NTV have no conflicts of interest.

Consent for Publication

Consent for publication was obtained for every individual person’s data included in the study.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study was approved by our Institutional Review Board (IRB).

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Informed consent was obtained from all individual participants included in the study.

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Kennedy, S.A., Faughnan, M.E., Vozoris, N.T. et al. Reperfusion of Pulmonary Arteriovenous Malformations Following Embolotherapy: A Randomized Controlled Trial of Detachable Versus Pushable Coils. Cardiovasc Intervent Radiol 43, 904–909 (2020). https://doi.org/10.1007/s00270-020-02422-8

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  • DOI: https://doi.org/10.1007/s00270-020-02422-8

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