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J Pediatr. 2004 Dec;145(6):826-31.

Pulmonary arteriovenous malformations in children: outcomes of transcatheter embolotherapy.

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Department of Medicine, Division of Respiratory Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.



To describe outcomes of transcatheter embolotherapy (TCE) in children with pulmonary arteriovenous malformations (PAVMs).


Chart and imaging review of all children (age </=18 years) treated for PAVMs by TCE at three hereditary hemorrhagic telangiectasia centers.


All 42 treated patients were included, with a mean age of 12 years (range, 4 to 18). Cyanosis was present in 25 of 42 patients (60%). Hemoptysis had occurred in 3 of 42 patients (7%) and neurologic complications (stroke, cerebral abscess) occurred in 8 patients (19%) before assessment. PAVMs were focal in 30 of 42 (71%) and diffuse in 12 of 42 (29%) patients. TCE was performed for 172 PAVMs and 35 diffuse regions (regional TCE). Follow-up was obtained in 38 of 42 (90%) patients (mean, 7 years). After TCE in patients with focal PAVMs, oxygenation improved significantly, with no further complications from the PAVMs. Reperfusion was noted in 23 of 153 (15%) PAVMs. Eighteen of 23 (78 %) of these were retreated, with documented aneurysmal involution in 10 of 13 (77%) patients. TCE complications included pleuritic chest pain (24% of sessions) and deployment complications (device paradoxical embolization or device misplacement) (3% of sessions, 1% of PAVMs), with no long-term complications.


PAVMs cause life-threatening complications in children; treatment with TCE is safe, with complication rates comparable to adult rates.

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