Clinical StudiesClinical and Anatomic Outcomes after Embolotherapy of Pulmonary Arteriovenous Malformations
Section snippets
Patients
Previously unreported patients were enrolled in this prospective study over a 3-year period from July 1, 1996, to June 30, 1999. Approval from our institutional review board (Human Investigation Committee) was obtained. Patients underwent evaluation for manifestations of pulmonary AVM and HHT. This consisted of a thorough history and physical examination, baseline pulse oximetry for oxygen saturation, often an arterial blood gas analysis for oxygen tension, and an imaging evaluation. Imaging
Patients and Embolization Data
One hundred fifty-five patients had embolization of pulmonary AVMs during the study period, of whom 148 (95%) had HHT. There were 65 male patients and 90 female patients, with a mean age of 45 years (range, 7–77 y). Seven patients were children younger than 18 years of age, with ages ranging from 7 to 18 years and a mean of 12 years. Information on clinical manifestations is available for 154 of these patients (Table 1).
Four hundred fifteen pulmonary AVMs were embolized in 205 procedures; 50
DISCUSSION
Pulmonary AVMs are well-known to predispose patients to significant morbidity other than just the effects of hypoxemia (3, 6, 24). In this study, one third of patients had a history of stroke or transient ischemic attack, whereas 9% had previous brain abscesses, 6% had other infections, and 3% had previous lung hemorrhage. The danger of leaving a pulmonary AVM alone after it has been diagnosed has also been demonstrated by Swanson et al (7), who found that five of 15 patients available for
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2023, Academic RadiologyCitation Excerpt :Complex PAVMs have more than one feeding arteries or draining veins. Because of the complex anatomy and multiple feeders, complex PAVMs pose technical challenges to achieving complete occlusion and may lead to persistence of the PAVM (1,4,8,34). There is no clear consensus on treating PAVMs secondary to HHT in children < 12 years who are asymptomatic.
R.I.W. and K.J.H. are supported in part by grants from the March of Dimes (grant HHT-FY04-677), the Josephine Lawrence Hopkins Foundation, and Yale– New Haven Hospital General Clinical Research Unit Grant NIH M01-RR-00125. None of the authors have identified a conflict of interest.
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Current address: Department of Radiology, Massachusetts General Hospital, Boston, MA.