|
 |
|
|||||||
|
|||||||||
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Copyright ©ERS Journals Ltd 2008
Embolisation of pulmonary arteriovenous malformations: no consistent effect on pulmonary artery pressure
1 NHLI Cardiovascular Sciences Unit, Imperial College London, 2 Respiratory Medicine, and 3 Dept of Imaging, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.
CORRESPONDENCE: C. L. Shovlin, NHLI Cardiovascular Sciences Unit, Imperial College London, Hammersmith Hospital, Du Cane Road, London, W12 0NN, UK. Fax: 44 2083831640. E-mail: c.shovlin{at}imperial.ac.uk
Keywords: Brain abscess, hypoxaemia, nosebleeds, oxygen saturation, right-to-left shunt, stroke
Received: September 25, 2007
Accepted March 3, 2008
Increasing evidence supports the use of embolisation to treat pulmonary arteriovenous malformations (AVMs). Most pulmonary AVM patients have hereditary haemorrhagic telangiectasia (HHT), a condition that may be associated with pulmonary hypertension.
The current authors tested whether pulmonary AVM embolisation increases pulmonary artery pressure (Ppa) in patients without baseline severe pulmonary hypertension. Ppa was measured at the time of pulmonary AVM embolisation in 143 individuals, 131 (92%) of whom had underlying HHT. Angiography/embolisation was not performed in four individuals with severe pulmonary hypertension, whose systemic arterial oxygen saturation exceeded levels usually associated with dyspnoea in pulmonary AVM patients.
In 143 patients undergoing pulmonary AVM embolisation, Ppa was significantly correlated with age, with the most significant increase occurring in the upper quartile (aged >58 yrs). In 43 patients with repeated measurements, there was no significant increase in Ppa as a result of embolisation. In half, embolisation led to a fall in Ppa. The maximum rise in mean Ppa was 8 mmHg: balloon test occlusion was performed in one of these individuals, and did not predict the subsequent rise in Ppa following definitive embolisation of the pulmonary AVMs.
In the present series of patients, which excluded those with severe pulmonary hypertension, pulmonary artery pressure was not increased significantly by pulmonary arteriovenous malformation embolisation.
This article has been cited by other articles:
|
|
 |
|
  S. Al-Saleh, M. Mei-Zahav, M. E. Faughnan, I. B. MacLusky, S. Carpenter, M. Letarte, and F. Ratjen Screening for pulmonary and cerebral arteriovenous malformations in children with hereditary haemorrhagic telangiectasia Eur. Respir. J., October 1, 2009; 34(4): 875 - 881. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. Cottin, D. Gamondes, A. Schuller, M. Coudurier, S. Dupuis-Girod, F. Tronc, and J-F. Cordier Near-fatal haemorrhage from pulmonary arteriovenous malformation in HHT with increased cardiac output Eur. Respir. Rev., September 1, 2009; 18(113): 190 - 192. [Full Text] [PDF]
|
|
|
|
 |
|
 L B Smoot, D Obler, D B McElhinney, K Boardman, B-L Wu, V Lip, and M P Mullen Clinical features of pulmonary arterial hypertension in young people with an ALK1 mutation and hereditary haemorrhagic telangiectasia Arch. Dis. Child., July 1, 2009; 94(7): 506 - 511. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Faughnan, J. T. Granton, and L. H. Young The pulmonary vascular complications of hereditary haemorrhagic telangiectasia Eur. Respir. J., May 1, 2009; 33(5): 1186 - 1194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. L. Shovlin, J. S. R. Gibbs, and J. E. Jackson Management of pulmonary arteriovenous malformations in pulmonary hypertensive patients: a pressure to embolise? Eur. Respir. Rev., March 1, 2009; 18(111): 4 - 6. [Full Text] [PDF]
|
|
|
|
|
|
D. Montani, L. C. Price, B. Girerd, T. Chinet, P. Lacombe, G. Simonneau, and M. Humbert Fatal rupture of pulmonary arteriovenous malformation in hereditary haemorrhagic telangiectasis and severe PAH Eur. Respir. Rev., March 1, 2009; 18(111): 42 - 46. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |