264 - Efficacy of Combined Venous Sac and Feeding Artery Embolization: A Review of 154 Pulmonary Arteriovenous Malformations

Tuesday, April 14, 2026

4:12 PM - 4:21 PM ET

Author/Co-author(s)

AS

Abin Sajan, MD

Resident Physician
Columbia University Medical Center, United States

Presenting Author(s)

SF

Samuel Fordyce, MD

Resident Physician
Columbia University, United States

Author/Co-author(s)

Connie Liou, MD

Resident Physician
Columbia University, United States
Kiyon Naser-Tavakolian, MD

Assistant Professor Interventional Radiology
Columbia University, United States
SR

Stephen P. Reis, MD

Associate Professor Interventional Radiology
Columbia University, United States
Asad Baig, MD

Assistant Professor Interventional Radiology
Columbia University, United States
VK

Venkatesh P. Krishnasamy, MD (he/him/his)

Associate Professor
University of Alabama at Birmingham, United States
Tarub S. Mabud, MD, MS

Resident Physician
New York University Grossman School of Medicine, United States
VS

Vladimir Sheynzon, MD, MBA

Associate Professor
Columbia University - Vascular and Interventional Radiology, United States

Purpose: To evaluate the safety and efficacy of venous sac embolization (VSE) with feeding artery embolization in the management of pulmonary arteriovenous malformations (PAVMs).

Materials and Methods: Sixty patients (45 female and 15 male, median age 48 years) with 154 untreated PAVMs (92% simple, 8% complex) were analyzed over a 10-year period. Technical success was measured by angiographic occlusion or stasis, while clinical success required a 70% reduction in AVM feeding vessel or sac size. Pre and post computed tomography images were compared for outcome analysis. The following data was collected: patient demographics, follow-up period, baseline diameters of the feeding artery, venous sac, and draining vein, draining vein diameter after treatment, and decrease in the size of the draining vein, including the number reaching a threshold of 70% decrease.

Results: AVMs were treated at the nidus (74%) or distally (26%), using coils (98%), plugs (1.7%), or Onyx (0.6%). Mean pretreatment feeding artery, draining vein and sac diameters were 3.23mm (SD 2.31), 3.91mm (SD 2.87) and 12mm (SD 8) mm respectively with post-treatment measurements of 0.43mm (SD 1.38), 1.07mm (SD 2.14) and 2.6mm (SD 4.9) respectively. In univariate analysis, pretreatment feeding artery diameter significantly affected the log odds of clinical success (P=0.016). Additionally, the changes in draining vein size and sac diameter were associated with technical success (P=0.04 and 0.02 respectively). No major adverse events were reported.

Conclusion: Combination venous sac and feeding artery embolization was associated with high rates of technical and clinical success.