Document Detail


Outpatient single-session pulmonary arteriovenous malformation embolization.
MedLine Citation:
PMID:  19683942     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Pulmonary arteriovenous malformation (PAVM) embolization has traditionally been performed as an inpatient procedure, often with sequential procedures to treat multiple lesions. This approach is costly, inconveniences the patient, and may lead to noncompliance with embolotherapy. In the authors' hereditary hemorrhagic telangiectasia (HHT) center, all PAVM embolizations in teenagers and adults are performed in the outpatient setting and all accessible PAVMs are treated in a single session if possible. The present report describes results from this center on an intent-to-treat basis. MATERIALS AND METHODS: Fifty-one patients whose ages ranged from 15 to 78 years (mean, 44 y), 47 with a confirmed diagnosis of HHT, underwent outpatient embolization in 63 procedures. Multiple procedures were performed when PAVMs were too numerous for single-session treatment (n = 7) or for PAVM recurrence/growth (n = 5). Planned multiple sessions were performed on consecutive days or at longer intervals at patient request. Patients were discharged after a 2-hour observation period. RESULTS: Outpatient single-session embolization was achieved in 44 of 51 patients (86%). When four or fewer PAVMs were present, single-session therapy was successful in 100% of cases. One patient with 10 PAVMs was admitted overnight at her request to complete the embolization the next day. All others were successfully treated as outpatients. No patient required admission during the postoperative period. A mean of 2.4 PAVMs were embolized per procedure (range, 1-9). CONCLUSIONS: Outpatient PAVM embolization is well tolerated, with single-session embolization of all PAVMs achievable in more than 85% of patients.
Authors:
Scott O Trerotola; Reed E Pyeritz; Barbara A Bernhardt
Publication Detail:
Type:  Journal Article     Date:  2009-08-15
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  20     ISSN:  1535-7732     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1287-91     Citation Subset:  IM    
Affiliation:
Department of Radiology, Division of Interventional Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. streroto@uphs.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Ambulatory Care / methods*
Angiography / methods
Arteriovenous Malformations / radiography,  therapy*
Embolization, Therapeutic / methods*
Female
Humans
Male
Middle Aged
Pulmonary Artery / abnormalities*,  radiography
Pulmonary Veins / abnormalities*,  radiography
Radiography, Interventional / methods*
Retrospective Studies
Telangiectasia, Hereditary Hemorrhagic / radiography,  therapy*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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