Background

To evaluate patient radiation dose and procedural duration recorded during pulmonary arteriovenous malformation (PAVM) embolisation performed using high-frequency jet ventilation (HFJV) as compared with conventional intermittent positive pressure ventilation (IPPV)

Methods

Patients undergoing PAVM embolisation with HFJV assistance after April 2017 were retrospectively identified as group A, and those treated with IPPV before April 2017 as group B. Primary outcomes were patient radiation dose and procedural duration between groups A and B. Secondary outcomes were difference in diaphragmatic excursion between groups A and B, in group A with/without HFJ assistance, technical/clinical success, and complications.

Results

Twelve PAVMs were embolised in 5 patients from group A, and 15 PAVMs in 10 patients from group B. Mean patient radiation was significantly lower in group A than in group B (54,307 ± 33,823 mGy cm² [mean ± standard deviation] versus 100,704 ± 43,930 mGy cm²; p = 0.022). Procedural duration was 33.4 ± 16.1 min in group A versus 57.4 ± 14.9 min in group B (p = 0.062). Diaphragmatic excursion was significantly lower in group A (1.3 ± 0.4 mm) than in group B (19.7 ± 5.2 mm; p < 0.001) and lower with near statistical significance in group A with HFJV than without HFJV (1.3 ± 0.4 mm versus 10.9 ± 3.1 mm; p = 0.062). Technical and clinical success was 100% in both groups, without relevant complications.

Conclusion

HFJV-assisted PAVM embolisation is a safe, feasible technique resulting in reduced patient radiation doses and procedural time.

中文翻译：

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使用高频喷射通气栓塞肺动静脉畸形：减少呼吸运动的好处。

背景

为了评估与常规间歇性正压通气（IPPV）相比，使用高频喷射通气（HFJV）进行的肺动静脉畸形（PAVM）栓塞期间记录的患者辐射剂量和手术时间

方法

回顾性地将2017年4月之后接受HFJV辅助的PAVM栓塞的患者归为A组，并将2017年4月之前接受IPPV治疗的患者归为B组。主要结局是患者放射剂量和A和B组之间的手术时间。次要结局是diaphragm肌差异A组和B组之间的短途旅行，A组在有/无HFJ协助下的技术，临床成功和并发症。

结果

A组的5例患者栓塞了12例PAVM，B组的10例患者栓塞了15例PAVM。A组的平均患者放射线显着低于B组（54,307±33,823 mGy cm ² [平均值±标准差]与100,704± 43,930 mGy cm ²；p  = 0.022）。A组的手术时间为33.4±16.1分钟，而B组为57.4±14.9分钟（p  = 0.062）。A组的肌偏移（1.3±0.4 mm）明显低于B组（19.7±5.2 mm; p  <0.001），并且在有HFJV的A组中，group肌偏移明显低于具有HFJV的A组（1.3±0.4 mm和10.9± 3.1毫米; p = 0.062）。两组的技术和临床成功率为100％，无相关并发症。

结论

HFJV辅助的PAVM栓塞术是一种安全，可行的技术，可减少患者的放射剂量和手术时间。