Pulmonary arteriovenous malformations and embolic complications in patients with hereditary hemorrhagic telangiectasia

• Published in: Archivos de bronconeumología (English ed.) 2014-07, Vol.50 (7), p.301-304
• Main Authors: Angriman, Federico, Ferreyro, Bruno L, Wainstein, Esteban J, Serra, Marcelo M
• Format: Article
• Language: eng ; spa
• Subjects: Adult; Arteriovenous Malformations - etiology; Cross-Sectional Studies; Embolism - etiology; Female; Humans; Male; Middle Aged; Pulmonary Artery - abnormalities; Pulmonary Veins - abnormalities; Telangiectasia, Hereditary Hemorrhagic - complications
• ISSN: 1579-2129
• DOI: 10.1016/j.arbres.2013.08.006

Patients with hereditary hemorrhagic telangiectasia (HHT) and pulmonary arteriovenous malformation (PAVM) face higher risk of embolic complications. It is not clear whether poor outcomes are related to PAVM severity or pulmonary symptoms. Furthermore, there is currently no available data on HHT patients in Argentina. We conducted a cross sectional study in a teaching hospital in Buenos Aires, Argentina. We describe baseline characteristics of HHT and compare the prevalence of embolic complications in patients with significant PAVM compared to patients without significant PAVM. One hundred and eight consecutive patients were included. Significant PAVM was defined as: contrast echocardiography grade 2 or greater; bilateral PAVM or feeding artery bigger than 3mm; or previous PAVM treatment. Primary composite outcome was defined as: cerebrovascular accident, cerebral abscess or peripheral embolism. 20% of participants had embolic complications, the most frequent one was stroke. Embolic complications were associated with significant PAVM and respiratory symptoms.