Management of pulmonary arteriovenous malformations involves additional factors aside from the diameter of feeding arteries: a 3-year case-case retrospective analysis

• Published in: Respiratory research 2022-04, Vol.23 (1), p.107-107, Article 107
• Main Authors: Ma, Xu, Li, Ling-Ling, Yu, Dong, Jie, Bing, Jiang, Sen
• Format: Article
• Language: English
• Subjects: Abscesses; Age; Arteries; Arteriovenous Fistula; Arteriovenous Malformations - diagnostic imaging; Arteriovenous Malformations - therapy; Central nervous system; Dyspnea; Embolisation; Embolization; Embolization, Therapeutic; Feeding; Health services; Hemorrhage; Hereditary haemorrhagic telangiectasia; Humans; Hypoxia; Lung diseases; Medical records; Nervous system; Patients; Pulmonary arteries; Pulmonary arteriovenous malformation; Pulmonary Artery - abnormalities; Pulmonary Artery - diagnostic imaging; Pulmonary Veins - abnormalities; Regression analysis; Respiration; Retrospective Studies; Statistical analysis; Stroke; Telangiectasia, Hereditary Hemorrhagic - epidemiology; Thoracic surgery; Transient ischaemic attack; Transient ischemic attack; Veins & arteries
• ISSN: 1465-993X; 1465-9921; 1465-993X; 1465-9921
• DOI: 10.1186/s12931-022-02030-9

Pulmonary arteriovenous malformations (PAVMs) are rare but cause various manifestations. Although the diameter of feeding arteries has been linked to treatment decisions, relationships among the characteristics of PAVMs, clinical symptoms, and treatment effect remain unclear. The present study was performed to investigate how collective characteristics of PAVMs relate to clinical symptoms and to provide proper treatment recommendations for patients with PAVMs. We retrospectively analysed 838,447 patients' radiographic data and medical records from January 2018 to December 2020. Patients were included if a PAVM was radiographically detected for the first time in our hospital. Ordered multivariable logistic regression and hierarchical multiple regression were performed to analyse the relationships between characteristics of PAVMs and various clinical symptoms. We investigated the management of PAVMs in four tertiary university hospitals. Detection rate of PAVMs was 0.025% (207/838,447), and 37.6% of patients (78/207) also had hereditary haemorrhagic telangiectasia. Eight patients were diagnosed with bilateral diffuse PAVMs. Two hundred thirty-six lesions were detected in 199 patients, and the mean diameter of the feeding artery was 4.13 ± 1.92 mm. Most PAVMs were the simple type and located in the peripheral pulmonary area. In total, 34.3% of patients (71/207) were symptom-free; remaining patients showed various manifestations, and respiratory symptoms were most common (dyspnoea on exertion, 47.8%). The diameter of the feeding artery and the type and the number of PAVMs were correlated with hypoxaemia (P