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DOI: 10.1055/s-0037-1607033
Contemporary Management of Pulmonary Arteriovenous Malformations
Publikationsverlauf
Publikationsdatum:
18. September 2017 (online)
Abstract
Pulmonary arteriovenous malformations (PAVMs) are atypical vascular structures involving a direct connection between the pulmonary arterial and venous circulations. While PAVMs are a relatively uncommon disorder, unmanaged cases are at risk for the development of serious complications including embolization and infection. Since their first description in 1897, PAVMs have been identified and treated in a variety of ways. Advancements in diagnostic methods and operative techniques have allowed for more effective treatment of the disease. Most recently, the use of vascular plug transcatheter embolization has been described as an effective therapeutic procedure in the management of PAVMs. In this report, we present our experience with nine cases of PAVMs treated at the University of Kentucky, including special consideration of an exemplary case that illustrates the typical course of treatment for the disease.
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References
- 1 Shovlin CL, Jackson JE. Pulmonary vascular abnormalities. Murray and Nadel's Textbook of Respiratory Medicine. Philadelphia: Elsevier; 2016: 1081-1095
- 2 Churton T. Multiple aneurysm of pulmonary artery. BMJ 1897; 1: 1223
- 3 Rodes CB. Cavernous hemangiomas of the lung with secondary polycythemia. JAMA 1938; 110: 1914
- 4 Smith HL, Horton BT. Arteriovenous fistula of the lung associated with polycythemia vera: report of a case in which the diagnosis was made clinically. Am Heart J 1939; 18: 589-592
- 5 Sloan RD, Cooley RN. Congenital pulmonary arteriovenous aneurysm. Am J Roentgenol Radium Ther Nucl Med 1953; 70 (02) 183-210
- 6 Nakayama M, Nawa T, Chonan T. , et al. Prevalence of pulmonary arteriovenous malformations as estimated by low-dose thoracic CT screening. Intern Med 2012; 51 (13) 1677-1681
- 7 Cartin-Ceba R, Swanson KL, Krowka MJ. Pulmonary arteriovenous malformations. Chest 2013; 144 (03) 1033-1044
- 8 Goodenburger DM, Chakinala M. Pulmonary arteriovenous malformations. Fishman's Pulmonary Diseases and Disorders. New York: McGraw-Hill Education; 2015
- 9 Shumacker Jr HB, Waldhausen JA. Pulmonary arteriovenous fistulas in children. Ann Surg 1963; 158: 713-720
- 10 Gossage JR, Kanj G. Pulmonary arteriovenous malformations. A state of the art review. Am J Respir Crit Care Med 1998; 158 (02) 643-661
- 11 White Jr RI, Mitchell SE, Barth KH. , et al. Angioarchitecture of pulmonary arteriovenous malformations: an important consideration before embolotherapy. AJR Am J Roentgenol 1983; 140 (04) 681-686
- 12 Faughnan ME, Palda VA, Garcia-Tsao G. , et al; HHT Foundation International - Guidelines Working Group. International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet 2011; 48 (02) 73-87
- 13 Shovlin CL, Guttmacher AE, Buscarini E. , et al. Diagnostic criteria for hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome). Am J Med Genet 2000; 91 (01) 66-67
- 14 Shovlin CL. Pulmonary arteriovenous malformations. Am J Respir Crit Care Med 2014; 190 (11) 1217-1228
- 15 Santhirapala V, Williams LC, Tighe HC, Jackson JE, Shovlin CL. Arterial oxygen content is precisely maintained by graded erythrocytotic responses in settings of high/normal serum iron levels, and predicts exercise capacity: an observational study of hypoxaemic patients with pulmonary arteriovenous malformations. PLoS One 2014; 9 (03) e90777
- 16 Santhirapala V, Chamali B, McKernan H. , et al. Orthodeoxia and postural orthostatic tachycardia in patients with pulmonary arteriovenous malformations: a prospective 8-year series. Thorax 2014; 69 (11) 1046-1047
- 17 Shovlin CL, Jackson JE, Bamford KB. , et al. Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia. Thorax 2008; 63 (03) 259-266
- 18 Moussouttas M, Fayad P, Rosenblatt M. , et al. Pulmonary arteriovenous malformations: cerebral ischemia and neurologic manifestations. Neurology 2000; 55 (07) 959-964
- 19 Clark K, Pyeritz RE, Trerotola SO. Angina pectoris or myocardial infarctions, pulmonary arteriovenous malformations, hereditary hemorrhagic telangiectasia, and paradoxical emboli. Am J Cardiol 2013; 112 (05) 731-734
- 20 Shovlin CL, Wilmshurst P, Jackson JE. Pulmonary arteriovenous malformations and other pulmonary aspects of HHT. Eur Respir Mon 2011; 54: 218-245
- 21 Velthuis S, Buscarini E, Mager JJ. , et al. Predicting the size of pulmonary arteriovenous malformations on chest computed tomography: a role for transthoracic contrast echocardiography. Eur Respir J 2014; 44 (01) 150-159
- 22 Hepburn J, Dauphinee JA. Successful removal of hemangioma of the lung followed by the disappearance of polycythemia. Am J Med Sci 1942; 204: 681
- 23 Hodgson CH, Burchell HB, Good CA, Clagett OT. Hereditary hemorrhagic telangiectasia and pulmonary arteriovenous fistula: survey of a large family. N Engl J Med 1959; 261: 625-636
- 24 Porstmann W. Therapeutic embolization of arteriovenous pulmonary fistula by catheter technique. Current Concepts in Pediatric Radiology. Berlin: Springer; 1977: 23-31
- 25 Terry PB, White Jr RI, Barth KH, Kaufman SL, Mitchell SE. Pulmonary arteriovenous malformations. Physiologic observations and results of therapeutic balloon embolization. N Engl J Med 1983; 308 (20) 1197-1200
- 26 Hsu CC, Kwan GN, Thompson SA, Evans-Barns H, van Driel ML. Embolisation for pulmonary arteriovenous malformation. Cochrane Database Syst Rev 2015; 1: CD008017
- 27 Jackson JE, Whyte MK, Allison DJ, Hughes JM. Coil embolization of pulmonary arteriovenous malformations. Cor Vasa 1990; 32 (03) 191-196
- 28 Wang W, Li H, Tam MD, Zhou D, Wang DX, Spain J. The amplatzer vascular plug: a review of the device and its clinical applications. Cardiovasc Intervent Radiol 2012; 35 (04) 725-740
- 29 Abdel Aal AK, Massoud MO, Elantably DM. Does the type and size of Amplatzer vascular plug affect the occlusion time of pulmonary arteriovenous malformations?. Diagn Interv Radiol 2017; 23 (01) 61-65
- 30 Trerotola SO, Pyeritz RE. Does use of coils in addition to amplatzer vascular plugs prevent recanalization?. AJR Am J Roentgenol 2010; 195 (03) 766-771
- 31 Trerotola SO, Pyeritz RE. PAVM embolization: an update. AJR Am J Roentgenol 2010; 195 (04) 837-845
- 32 Choong CK, Goodenberger DM, Picus D, Meyers BF. Surgical treatment of recurrent transient ischemic attacks and hemoptysis in a young man with multiple pulmonary arteriovenous malformations. J Thorac Cardiovasc Surg 2005; 130 (05) 1456-1458
- 33 Reynaud-Gaubert M, Thomas P, Gaubert JY. , et al. Pulmonary arteriovenous malformations: lung transplantation as a therapeutic option. Eur Respir J 1999; 14 (06) 1425-1428
- 34 Howard LSGE, Santhirapala V, Murphy K. , et al. Cardiopulmonary exercise testing demonstrates maintenance of exercise capacity in patients with hypoxemia and pulmonary arteriovenous malformations. Chest 2014; 146 (03) 709-718
- 35 Finnamore H, Le Couteur J, Hickson M, Busbridge M, Whelan K, Shovlin CL. Hemorrhage-adjusted iron requirements, hematinics and hepcidin define hereditary hemorrhagic telangiectasia as a model of hemorrhagic iron deficiency. PLoS One 2013; 8 (10) e76516
- 36 Shovlin C, Bamford K, Wray D. Post-NICE 2008: Antibiotic prophylaxis prior to dental procedures for patients with pulmonary arteriovenous malformations (PAVMs) and hereditary haemorrhagic telangiectasia. Br Dent J 2008; 205 (10) 531-533
- 37 Shovlin CL, Winstock AR, Peters AM, Jackson JE, Hughes JM. Medical complications of pregnancy in hereditary haemorrhagic telangiectasia. QJM 1995; 88 (12) 879-887
- 38 Swinburne AJ, Fedullo AJ, Gangemi R, Mijangos JA. Hereditary telangiectasia and multiple pulmonary arteriovenous fistulas. Clinical deterioration during pregnancy. Chest 1986; 89 (03) 459-460
- 39 Shovlin CL, Sodhi V, McCarthy A, Lasjaunias P, Jackson JE, Sheppard MN. Estimates of maternal risks of pregnancy for women with hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): suggested approach for obstetric services. BJOG 2008; 115 (09) 1108-1115
- 40 Gershon AS, Faughnan ME, Chon KS. , et al. Transcatheter embolotherapy of maternal pulmonary arteriovenous malformations during pregnancy. Chest 2001; 119 (02) 470-477
- 41 Gomes MR, Bernatz PE, Dines DE. Pulmonary arteriovenous fistulas. Ann Thorac Surg 1969; 7 (06) 582-593
- 42 Sluiter-Eringa H, Orie NG, Sluiter HJ. Pulmonary arteriovenous fistula. Diagnosis and prognosis in noncomplainant patients. Am Rev Respir Dis 1969; 100 (02) 177-188
- 43 Dines DE, Arms RA, Bernatz PE, Gomes MR. Pulmonary arteriovenous fistulas. Mayo Clin Proc 1974; 49 (07) 460-465
- 44 Dines DE, Seward JB, Bernatz PE. Pulmonary arteriovenous fistulas. Mayo Clin Proc 1983; 58 (03) 176-181
- 45 Puskas JD, Allen MS, Moncure AC. , et al. Pulmonary arteriovenous malformations: therapeutic options. Ann Thorac Surg 1993; 56 (02) 253-257 , discussion 257–258
- 46 Bosher Jr LH, Blake DA, Byrd BR. An analysis of the pathologic anatomy of pulmonary arteriovenous aneurysms with particular reference to the applicability of local excision. Surgery 1959; 45 (01) 91-104
- 47 Andersen PE, Kjeldsen AD. Clinical and radiological long-term follow-up after embolization of pulmonary arteriovenous malformations. Cardiovasc Intervent Radiol 2006; 29 (01) 70-74
- 48 Hart JL, Aldin Z, Braude P, Shovlin CL, Jackson J. Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients. Eur Radiol 2010; 20 (11) 2663-2670