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Pulmonary Arteriovenous Malformations in Non-hereditary Hemorrhagic Telangiectasia Patients: An 18-Year Retrospective Study.
Albitar, Hasan Ahmad Hasan; Segraves, Justin M; Almodallal, Yahya; Pinto, Catarina Aragon; De Moraes, Alice Gallo; Iyer, Vivek N.
Afiliação
  • Albitar HAH; Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
  • Segraves JM; Division of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA.
  • Almodallal Y; Department of Pediatrics, Mayo Clinic, Rochester, MN, USA.
  • Pinto CA; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
  • De Moraes AG; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
  • Iyer VN; Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. iyer.vivek@mayo.edu.
Lung ; 198(4): 679-686, 2020 08.
Article em En | MEDLINE | ID: mdl-32648120
ABSTRACT

PURPOSE:

Pulmonary arteriovenous malformations (PAVMs) are most commonly associated with hereditary hemorrhagic telangiectasia (HHT). Patients with PAVMs can present with serious complications including stroke, transient ischemic attack (TIA), and brain abscess. PAVMs are rare in non-HHT patients and little is known about this patient population. The aim of this retrospective study is to better understand clinical presentation and outcomes of PAVMs occurring exclusively in non-HHT patients.

METHODS:

Non-HHT patients with PAVMs at the Mayo Clinic-Rochester between 01/01/2000 and 12/31/2018 were reviewed. Patients with Curacao score > 1 were excluded. Demographics, imaging characteristics, neurological complications, and follow-up imaging were analyzed.

RESULTS:

Seventy-seven patients with PAVMs were identified. The mean age at diagnosis was 48.2 ± 18.3 years with female preponderance (59.7%). The majority of PAVMs had lower lobe predominance (66.7%) and were simple and single in 75.3% and 89.6% of cases, respectively. Most patients were asymptomatic (46.8%) with dyspnea being the most common symptom (28.6%). Neurologic complications occurred in 19.5% of patients. The majority of PAVMs were idiopathic (61%). Thirty patients (39%) had one or more possible risk factors including previous thoracic surgery (23.4%), congenital heart disease (19.5%), and chest trauma (10.4%). Embolization was performed in 37 (48.1%) patients and only 4 (5.2%) underwent surgical resection.

CONCLUSIONS:

Non-HHT PAVMs occur more commonly in females, are most commonly simple and single, and have lower lobe predominance and a high rate of neurologic complications. Potential predisposing risk factors were identified in about 40% of the cases. Clinicians should be aware of the risk of PAVM development in patients with history of chest trauma, congenital heart disease, lung infection/abscess, and thoracic surgery.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Malformações Arteriovenosas / Artéria Pulmonar / Veias Pulmonares / Telangiectasia / Hemoptise Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Malformações Arteriovenosas / Artéria Pulmonar / Veias Pulmonares / Telangiectasia / Hemoptise Idioma: En Ano de publicação: 2020 Tipo de documento: Article