Embolisation for pulmonary arteriovenous malformation

Hsu, Charlie; Kwan, Gigi N. C.; Thompson, Shane A; Evans-Barns, Hannah; Driel, Mieke van

doi:10.1002/14651858.cd008017.pub5

Cited by 43 publications

(41 citation statements)

References 51 publications

(37 reference statements)

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“…Pathologic pulmonary arteriovenous malformation is the direct communication between the branches of pulmonary artery and pulmonary vein in way that there is a shunts of normal lung capillaries which leads to chronic hypoxia 1,2,4 . The incidence of PAVM is 2-3 cases in 100.000 people 1,5,6 . In more than 80% of cases it is congenital anomaly (together with hereditary hemorrhagic telangiectasia or Osler-Weber-Rendu syndrome), and the rare cases are after trauma of the thoracic cavity, thoracic surgery, long-term hepatic cirrhosis, metastatic disease, stenosis of the mitral valve, infections and systemic amyloidosis 1-5, 7, 8 .…”

Section: Discussionmentioning

confidence: 99%

“…They are stabile in 75% of the cases or slow growth, and only in small number of cases PAVM can induce higher rate of morbidity and mortality because of no treatment 10 . Complications are brain abscess, stroke, hemoptysis and haemothorax, hypoxia, polycythemia, endocarditis, transitory ischemic attack, migraine and congestive hearth weakness 1,4,6 . Risk of neurological complications is higher in diffuse type PAVM, large shunt and feeding branch diameter more than 3 mm 11 and in untreated forms of PAVM in comparation to treated forms 4 .…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary arteriovenous malformation: Case report

et al. 2021

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Introduction. Pulmonary arteriovenous malformation (PAVM) is pathological communication between pulmonary artery and pulmonary vein, in way that it shunts normal alveolar capillary membrane resulting in inadequate blood oxygenation in this part of the lung parenchyma Modern therapy of PAVMs includes surgical treatment or endovascular embolization. Case report. A 30-year-old female patient had signs of parestesia and weakness of the extremities on the left side of her body. On physical examination there was only cyanotic discoloration of her lips and clubbing fingers. On the chest x-ray, in the right hemithorax, in the inferior region of the lung, there was relatively homogeneous and well defined shadow, intensity of the soft tissue, which was about 35 mm. A multislice computed tomography pulmonary angiography was performed and showed, in lung parenchyma on both sides, many PAVMs, of which the largest (35 mm) was in inferior right region of the lung on crossing between apical and posterior basal lung segment with 7 mm diameter feeding artery and 9 mm diameter draining vein. The selective pulmonary angiography was per-formed by Seldingers technique. Through sheath, we placed a plug with a diameter of 10 mm. The plug was expanded and a complete occlusion of the final part of the feeding branch of this PAVM was achieved (confirmed by control angiography). In that way, the PAVM was fully shut off from the circulation. In 3 months follow-up, the patient was feeling well, without any recorded complication. Conclusion. Endovascular embolization is recommended as therapy of the first choice for all of PAVMs that have feeding artery greater than 2 mm. Endovascular embolization has high success rate with minimal complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pulmonary arteriovenous malformation: Case report

et al. 2021

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“…Treatment of pulmonary bleeding is still one of the most pressing problems in surgery. Pulmonary bleeding is the most dangerous complication of a number of diseases [1,2]. There are 40 nosological forms that can be complicated by pulmonary hemorrhage (PH); some authors describe PH as a complication in more than 100 diseases [3,4].…”

Section: Introductionmentioning

confidence: 99%

Possibilities of Using Miniinvasive Catheter Technologies in the Treatment of Lung Bleeding

Ponomarova¹

2019

EUREKA: Health Sciences

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Aim – improve the results of the treatment of patients with pulmonary bleeding through widespread use of endovascular surgery methods for hemostasis. Materials and methods. Method of endovascular embolization of bronchial arteries is widely used in our clinic SI «Zaycev V. T. Institute of General and Emergency surgery of NAMS of Ukraine» not only as independent surgery in patients with LB, but also as way of preparation of patients with lung bleeding for planned thorax surgery. The most of the often spread nosological forms complicated by bleeding in our research were polycystic lung disease, chronic obstructive pulmonary disease, bronchiectasis disease, community-acquired pneumonia. Indications to the сatheter embolization procedure of bronchial arteries are the following: conservative treatment failure, hemoptysis in patients with bilateral inflammatory processes who was not prescribed surgical treatment for a range of reasons, absence of gross structural changes, lung resection, mainly in patients with oncologic lung injury, at massive and life-threatening profuse bleedings as a mean of temporary or constant hemostasis. Discussed treatment method is applied only in bleeding or within a 6 – 12 hour after its treatment. Successful result in embolization can be obtained in 79–99 %. Results. As a result of complete physical examination of patients with LB, it has been established that lung hemorrhage was the result of obstructive bronchitis in 14 patients (42 %), there was chronic obstructive pulmonary disease in 7 (21 %) patients and bronchiectasis was diagnosed in 6 (18 %) patients. In 2 (6 %) patients pulmonary hemorrhage was caused by community-acquired pneumonia. Central lung cancer was detected in 4 (12 %) patients. Conclusion. Therefore bronchial artery angiography gives high efficiency in solving the problem of hemostasis in oncological and nonspecific lung diseases, for determination of localization and source of bleeding. Endovascular occlusion of bronchial arteries in pulmonary hemorrhage permits: – to elaborate diagnosis because of the presence of specific angiographic signs of malignant tumour; – to perform effective endovascular hemostasis; – to gain time for stabilization the patient with the aim of planned surgical treatment.

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“…About 90% of individuals with PAVMs have hereditary hemorrhagic telangiectasia (HHT). [ 2 3 ] HHT is inherited as an autosomal dominant trait and most commonly results from a pathogenic sequence variant in ENG-encoding endoglin (HHT type 1/HHT1), ACVRL1-encoding ALK-1 (HHT type 2/HHT2), or SMAD4. [ 4 ] Non-HHT-related PAVMs are most commonly sporadic, or secondary to hepatopulmonary syndrome, caval pulmonary shunts, or trauma.…”

mentioning

confidence: 99%

“…[ 4 ] Non-HHT-related PAVMs are most commonly sporadic, or secondary to hepatopulmonary syndrome, caval pulmonary shunts, or trauma. [ 2 3 ]…”

mentioning

confidence: 99%