Pulmonary arteriovenous malformations in children: Outcomes of transcatheter embolotherapy - 24/08/11
, Ashraf Thabet, BA, Meir Mei-Zahav, MD, Maria Colombo, MD, Ian MacLusky, MD, Robert H. Hyland, MD, Robyn A. Pugash, MD, Peter Chait, MD, Katharine J. Henderson, MS, Robert I. White, MD
Reprint requests: Dr Marie E. Faughnan, St Michael's Hospital, 30 Bond St, Suite 6045, Toronto, Ontario, Canada M5B-1W8.Abstract |
Objective |
To describe outcomes of transcatheter embolotherapy (TCE) in children with pulmonary arteriovenous malformations (PAVMs).
Study design |
Chart and imaging review of all children (age ≤18 years) treated for PAVMs by TCE at three hereditary hemorrhagic telangiectasia centers.
Results |
All 42 treated patients were included, with a mean age of 12 years (range, 4 to 18). Cyanosis was present in 25 of 42 patients (60%). Hemoptysis had occurred in 3 of 42 patients (7%) and neurologic complications (stroke, cerebral abscess) occurred in 8 patients (19%) before assessment. PAVMs were focal in 30 of 42 (71%) and diffuse in 12 of 42 (29%) patients. TCE was performed for 172 PAVMs and 35 diffuse regions (regional TCE). Follow-up was obtained in 38 of 42 (90%) patients (mean, 7 years). After TCE in patients with focal PAVMs, oxygenation improved significantly, with no further complications from the PAVMs. Reperfusion was noted in 23 of 153 (15%) PAVMs. Eighteen of 23 (78 %) of these were retreated, with documented aneurysmal involution in 10 of 13 (77%) patients. TCE complications included pleuritic chest pain (24% of sessions) and deployment complications (device paradoxical embolization or device misplacement) (3% of sessions, 1% of PAVMs), with no long-term complications.
Conclusions |
PAVMs cause life-threatening complications in children; treatment with TCE is safe, with complication rates comparable to adult rates.
Le texte complet de cet article est disponible en PDF.Mots-clés : CP, HHT, PAVMs, TCE, SpO2
Plan
| Supported by the Squires Club, Nelson Arthur Hyland Foundation, Sonor Foundation, St Michael's Hospital Research Institute (M.E.F.), and March of Dimes grant HHT-FY03-677, Josephine Lawrence Hopkins Foundation, and General Clinical Research Center NIH grant M01-RR-00125 (R.I.W., K.H., and A.T.). |
Vol 145 - N° 6
P. 826-831 - décembre 2004 Retour au numéro
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