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https://www.readbyqxmd.com/read/29142484/contemporary-management-of-pulmonary-arteriovenous-malformations
#1
REVIEW
Nicholas Rauh, John Gurley, Sibu Saha
Pulmonary arteriovenous malformations (PAVMs) are atypical vascular structures involving a direct connection between the pulmonary arterial and venous circulations. While PAVMs are a relatively uncommon disorder, unmanaged cases are at risk for the development of serious complications including embolization and infection. Since their first description in 1897, PAVMs have been identified and treated in a variety of ways. Advancements in diagnostic methods and operative techniques have allowed for more effective treatment of the disease...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29141890/british-thoracic-society-clinical-statement-on-pulmonary-arteriovenous-malformations
#2
Claire L Shovlin, Robin Condliffe, James W Donaldson, David G Kiely, Stephen J Wort
Pulmonary arteriovenous malformations (PAVMs) are structurally abnormal vascular communications that provide a continuous right-to-left shunt between pulmonary arteries and veins. Their importance stems from the risks they pose (>1 in 4 patients will have a paradoxical embolic stroke, abscess or myocardial infarction while life-threatening haemorrhage affects 1 in 100 women in pregnancy), opportunities for risk prevention, surprisingly high prevalence and under-appreciation, thus representing a challenging condition for practising healthcare professionals...
December 2017: Thorax
https://www.readbyqxmd.com/read/29103837/persistent-pulmonary-arteriovenous-malformations-percutaneous-embolotherapy
#3
Ahmed Kamel Abdel Aal, Joseph Eason, Sherif Moawad, Khalid Mahmoud, Basant Farouk Hamed, Moustafa Omar Massoud, Nathan Ertel, Andrew Gunn, Rachel Oser, Souheil Saddekni
Pulmonary arteriovenous malformations (PAVM) are an uncommon entity that interventional radiologists may face in their clinical practice. Many of these lesions are treated successfully using endovascular techniques with satisfactory long-term results. However, some PAVMs respond poorly to initial interventional techniques. This article reviews the signs and symptoms of persistent PAVMs, illustrates different imaging modalities used to diagnose these lesions, and outlines mechanisms by which these lesions may persist...
September 21, 2017: Current Problems in Diagnostic Radiology
https://www.readbyqxmd.com/read/29071074/long-term-outcomes-of-patients-with-pulmonary-arteriovenous-malformations-considered-for-lung-transplantation-compared-with-similarly-hypoxaemic-cohorts
#4
Claire L Shovlin, Elisabetta Buscarini, J Michael B Hughes, David J Allison, James E Jackson
INTRODUCTION: Pulmonary arteriovenous malformations (PAVMs) may not be amenable to treatment by embolisation or surgical resection, and many patients are left with significant hypoxaemia. Lung transplantation has been undertaken. There is no guidance on selection criteria. METHODS: To guide transplantation listing assessments, the outcomes of the six patients who had been considered for transplantation were compared with a similarly hypoxaemic patient group recruited prospectively between 2005 and 2016 at the same UK institution...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29048420/characterization-of-pulmonary-arteriovenous-malformations-in-acvrl1-versus-eng-mutation-carriers-in-hereditary-hemorrhagic-telangiectasia
#5
Weiyi Mu, Zachary A Cordner, Kevin Yuqi Wang, Kate Reed, Gina Robinson, Sally Mitchell, Doris Lin
PurposePulmonary arteriovenous malformations (pAVMs) are major contributors to morbidity and mortality in hereditary hemorrhagic telangiectasia (HHT). Mutations in ENG and ACVRL1 underlie the vast majority of clinically diagnosed cases. The aims of this study were to characterize and compare the clinical and morphologic features of pAVMs between these two genotype groups.MethodsSixty-six patients with HHT and affected family members were included. Genotype, phenotypic data, and imaging were obtained from medical records...
October 19, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29018941/pulmonary-arteriovenous-malformations-in-hereditary-haemorrhagic-telangiectasia-correlations-between-computed-tomography-findings-and-cerebral-complications
#6
Johan Etievant, Salim Si-Mohamed, Nicolas Vinurel, Sophie Dupuis-Girod, Evelyne Decullier, Delphine Gamondes, Chahera Khouatra, Vincent Cottin, Didier Revel
OBJECTIVES: Computed tomography (CT) is the modality of choice to characterise pulmonary arteriovenous malformations (PAVMs) in patients with hereditary haemorrhagic telangiectasia (HHT). Our objective was to determine if CT findings were associated with frequency of brain abscess and ischaemic stroke. METHODS: This retrospective study included patients with HHT-related PAVMs. CT results, i.e. PAVM presentation (unique, multiple, disseminated or diffuse), the number of PAVMs and the largest feeding artery size, were correlated to prevalence of ischaemic stroke and brain abscess...
October 10, 2017: European Radiology
https://www.readbyqxmd.com/read/29018013/stroke-resulting-from-an-isolated-pulmonary-arteriovenous-malformation
#7
Jakob Saidman, Hossam Abdou, Sridhar Sampath Kumar
Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech. Work-up was unclear and she was diagnosed with cryptogenic stroke. Follow-up transoesophageal echocardiogram was suggestive of an atrial septal defect, though no clear defect was evident...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28990732/first-use-of-micro-vascular-plugs-in-australia-endovascular-treatment-of-pulmonary-arteriovenous-malformation
#8
Liat Barrett, Nicholas I Brown, Varghese Pynadath Joseph
This report describes the first Australian experience with the Micro Vascular Plug System (MVP), as a permanent embolic device for the treatment of pulmonary arteriovenous malformations (PAVMs). MVPs deployed in small vessels between 2 mm and 5 mm are demonstrated to be feasible, safe and effective treatment for PAVMs.
October 9, 2017: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/28987686/can-the-pine-needle-sign-on-computed-tomography-be-used-to-differentiate-pulmonary-arteriovenous-malformation-from-its-mimics-analysis-based-on-dynamic-contrast-enhanced-chest-computed-tomography-in-adults
#9
Koji Tokunaga, Takeshi Kubo, Toshihide Yamaoka, Hiroyoshi Isoda, Kaori Togashi
OBJECTIVES/PURPOSE: To determine the diagnostic value of morphological features on computed tomography (CT) in the differentiation of pulmonary arteriovenous malformation (pAVM) and its mimics. MATERIALS AND METHODS: We retrospectively examined 59 consecutive patients (109 lesions) with initially suspected or occult pAVM who underwent contrast-enhanced chest CT from January 2006 to June 2016. All lesions were divided into two groups based on their diagnosis: AVM (n=93) and non-AVM (n=16)...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28944082/ultra-short-echo-time-magnetic-resonance-imaging-for-detection-of-pulmonary-arteriovenous-malformation-recanalization-after-coil-embolization-a-case-report-and-a-phantom-study
#10
Kohei Hamamoto, Emiko Chiba, Katsuhiko Matsuura, Tomohisa Okochi, Keisuke Tanno, Osamu Tanaka
A pulmonary arteriovenous malformation (PAVM) is a direct connection between the pulmonary arteries and veins for which metallic coil transcatheter embolization is the standard of care. Detecting recanalization after PAVM treatment is crucial, but direct visualization with computed tomography or magnetic resonance imaging (MRI) is generally difficult. Here, we report a case of a recanalized PAVM that was directly detected with ultra-short echo time MRI. The detection of these signals in the coils was confirmed in a phantom study...
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28936439/a-case-of-pulmonary-arteriovenous-malformation-role-of-interventional-radiology-in-diagnosis-and-treatment
#11
Pranav Sharma, Puneet Kochar, Salil Sharma, Nishant Gupta, Shuo Li, Kusum Hooda, Yogesh Kumar
Pulmonary arterio-venous malformations (PAVMs) are abnormal pulmonary arteries and pulmonary veins communicating directly without interposition of a capillary bed and about 80-90% of patients with PAVMs eventually may present with hereditary hemorrhagic telangiectasia (HHT), remaining ones are sporadic cases. On the other hand, about 15-35% of HHT patients may present with PAVMs. The PAVMs have a tendency to grow and increase in size over time and various factors like puberty, pregnancy and pulmonary arterial hypertension (PAH) affect growth...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28917138/pulmonary-venous-anomalies-causing-misdiagnosis-of-pulmonary-arteriovenous-malformations
#12
Cheng Ting Lin, Stefan Loy Zimmerman, Sally Elizabeth Mitchell, Elliot K Fishman
PURPOSE: To investigate pulmonary venous anomaly as a cause of pulmonary arteriovenous malformation (PAVM) misdiagnosis. MATERIALS AND METHODS: We reviewed adult patients within a 7.5-year period with CT scans initially diagnosed with PAVM and subsequent conventional pulmonary angiograms. RESULTS: Pulmonary arteriography showed no PAVM on arterial phase for 10 out of 99 patients, comprising the misdiagnosed group. Four misdiagnosed patients had pulmonary venous anomalies and six had nodular lesions on CT...
September 8, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28828102/non-contrast-enhanced-magnetic-resonance-angiography-using-time-spatial-labeling-inversion-pulse-technique-for-differentiation-between-pulmonary-varix-and-arteriovenous-malformation
#13
Kohei Hamamoto, Emiko Chiba, Katsuhiko Matsuura, Tomohisa Okochi, Keisuke Tanno, Osamu Tanaka
Pulmonary varix is a rare entity that presents as a focal aneurysmal dilatation of the pulmonary vein and is frequently mistaken for a pulmonary arteriovenous malformation (PAVM). It is important to distinguish between pulmonary varix and PAVM because the former does not usually require treatment. We present the findings of non-contrast-enhanced magnetic resonance angiography with the time-spatial labeling inversion pulse technique in case of pulmonary varix and PAVM and the utility of this method for differentiating between these diseases...
September 2017: Radiology Case Reports
https://www.readbyqxmd.com/read/28810087/multiple-pulmonary-arteriovenous-malformations-an-unusual-cause-of-shortness-of-breath-and-recurrent-strokes
#14
Kalyan C Potu, Shenjing Li, Shawn C Kelly, Julia A Prescott-Focht, Scott Pham
OBJECTIVE: To discuss an uncommon case of a patient with multiple pulmonary arteriovenous malformations (PAVMs) presenting with dyspnea on exertion and recurrent strokes. BACKGROUND: A 79-year-old woman with recent onset recurrent cerebrovascular accidents (CVAs) was referred to cardiology for evaluation of dyspnea on exertion. Clinical examination was unrevealing. METHODS: A transthoracic echocardiogram (TTE) with agitated saline was suggestive of an extra-cardiac shunt...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28746925/pulmonary-arteriovenous-malformations-are-associated-with-silent-brain-infarcts-in-hereditary-hemorrhagic-telangiectasia-patients
#15
Waleed Brinjikji, Deena M Nasr, Christopher P Wood, Vivek N Iyer
BACKGROUND AND PURPOSE: There is a high prevalence of right-to-left shunting pulmonary arteriovenous malformations (PAVMs), which are stroke risk factors, in hereditary hemorrhagic telangiectasia (HHT) patients. While the prevalence of ischemic complications in HHT patients is known, the prevalence of silent brain infarcts (SBI) remains unknown. The purpose of this study was to determine the prevalence and risk factors for SBI in HHT patients. MATERIALS AND METHODS: Our institutional HHT database was queried to identify HHT patients who received a baseline screening brain MRI from January 2000 to February 2017...
2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28736615/pulmonary-arteriovenous-malformations-complicated-by-splenic-infarction-and-abscess
#16
Jun Naito, Hajime Kasai, Masaki Suga, Toshihiko Sugiura, Nobuhiro Tanabe, Koichiro Tatsumi
Pulmonary arteriovenous malformation (PAVM) is an abnormal blood vessel connecting a pulmonary artery and a vein, and is accompanied by paradoxical embolism to other organs due to a right-to-left shunt. We report the case of a 66-year-old woman with PAVM complicated by splenic infarction and abscess. Although the PAVM had been detected on a chest image 2 years previously, and she had been advised to have further investigations, she decided not to follow this further at the time. She then visited our hospital complaining of worsening dyspnoea on exertion...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28716646/pulmonary-infarction-in-the-beginning-the-natural-history-of-pulmonary-infarction
#17
Peter B Terry, Philip Clay Buescher
BACKGROUND: Massive pulmonary emboli can cause an abrupt onset of symptoms simultaneous with large pulmonary artery occlusions. In contrast, the temporal relationship between pulmonary vascular occlusion by smaller emboli and the development of symptoms of pulmonary infarction is unknown. We describe the time interval between embolization and the onset of clinical symptoms and signs compatible with pulmonary infarction. METHODS: We examined the records of 56 patients with hereditary hemorrhagic telangiectasia (HHT) who underwent therapeutic balloon embolization of pulmonary arteriovenous malformation (PAVM) in a single center after noting that some of them experienced symptoms and signs compatible with pulmonary infarction...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28588815/familial-cerebral-abscesses-caused-by-hereditary-hemorrhagic-telangiectasia
#18
Pernille Mathiesen Tørring, Mathilde Faurholdt Lauridsen, Christine I Dali, Poul Erik Andersen, Lillian Bomme Ousager, Klaus Brusgaard, Anette Kjeldsen
In case of a cerebral abscess without known cause, Pulmonary arteriovenous malformations (PAVM) screening should be performed. If PAVM(s) is identified, Hereditary hemorrhagic telangiectasia (HHT) is very likely and should always be considered. This case shows the benefit of familial screening for HHT and PAVM.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28578477/prevalence-of-hereditary-hemorrhagic-telangiectasia-in-patients-operated-for-cerebral-abscess-a-retrospective-cohort-analysis
#19
L Larsen, C R Marker, A D Kjeldsen, F R Poulsen
It is well described that patients with pulmonary arteriovenous malformations (PAVMs) and Hereditary Hemorrhagic Telangiectasia (HHT) have an increased risk of cerebral abscess (CA). However, as both CA and HHT are rare, the proportion of patients with CA who are diagnosed with HHT has not been previously described. A retrospective study was carried out of all patients treated surgically for CA between January 1995 and September 2014 at the Department of Neurosurgery, Odense University Hospital. The cases were then cross-referenced with the Danish HHT database...
October 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28494714/is-the-hepatic-factor-a-mirna-that-maintains-the-integrity-of-pulmonary-microvasculature-by-inhibiting-the-vascular-endothelial-growth-factor
#20
Joseph J Vettukattil
BACKGROUND: The "hepatic factor," a molecule or group of molecules present in the hepatic venous blood, essential for the prevention of the development of pulmonary arteriovenous malformations (PAVMs) and right-to-left shunting has been a conceptual enigma in the understanding of many related conditions. METHODS: Patients with various forms of liver diseases including acute hepatic failure, and others with normal hepatic function like hereditary hemorrhagic telangiectasia (HHT), inflammatory and parasitic disorders, cardiogenic hepatopulmonary syndrome (cHPS) and skin disorders like Dyskeratosis congenita are all known to cause PAVMs...
2017: Current Cardiology Reviews
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