Follow-up interval for small untreated pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia

Autor: M. M. Murphy, T. M. O’Connor, David Ryan, A. P. Brady
Rok vydání: 2016
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
Adolescent
medicine.medical_treatment
Pulmonary Artery
Asymptomatic
Sensitivity and Specificity
030218 nuclear medicine & medical imaging
Arteriovenous Malformations
03 medical and health sciences
Young Adult
0302 clinical medicine
medicine.artery
otorhinolaryngologic diseases
Retrospective analysis
medicine
Thoracic ct
Humans
Radiology
Nuclear Medicine and imaging
Telangiectasia
Watchful Waiting
Hereditary haemorrhagic telangiectasia
Aged
business.industry
Reproducibility of Results
General Medicine
Middle Aged
Surgery
030228 respiratory system
Pulmonary Veins
Pulmonary artery
Disease Progression
Female
Radiography
Thoracic
Telangiectasia
Hereditary Hemorrhagic
Surveillance imaging
medicine.symptom
business
Tomography
X-Ray Computed
Watchful waiting
Follow-Up Studies
Zdroj: Clinical radiology. 72(3)
ISSN: 1365-229X
Popis: To investigate the natural history of untreated small (3 mm) and microscopic pulmonary arteriovenous malformations (PAVMs) in hereditary haemorrhagic telangiectasia (HHT) in order to discern the optimal frequency of follow-up thoracic computed tomography (CT).A retrospective analysis was performed on the follow-up data for definite and suspected HHT patients with untreated PAVMs.For small PAVMs in definite HHT (n=13), PAVM enlargement was identified in one patient (1/13, 7.7%) after 10.7 years follow-up and was successfully treated using transcatheter embolisation (TCE). For microscopic PAVMs in definite HHT (n=28), two patients (2/28, 7%) developed small asymptomatic PAVMs, which did not meet the size criteria for TCE after 6.8 years of follow-up. For small PAVMs in suspected HHT (n=5), feeding artery enlargement was seen in one patient (1/5, 20%) after 7.9 years, but again, this did not meet the size criteria for embolisation. No macroscopic PAVM development was identified after a median follow-up of 5.4 years in suspected HHT with microscopic PAVMs (n=20).For small and microscopic PAVMs in HHT, PAVM enlargement was found to be more infrequent than would be expected based on current guidelines; therefore, potentially challenging the current surveillance imaging recommendation of a repeat thoracic CT every 5 years.
Databáze: OpenAIRE
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