Pulmonary arteriovenous malformations in children: outcomes of transcatheter embolotherapy

J Pediatr. 2004 Dec;145(6):826-31. doi: 10.1016/j.jpeds.2004.08.046.


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

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

Results: 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.

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

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Arteriovenous Malformations / complications
  • Arteriovenous Malformations / physiopathology
  • Arteriovenous Malformations / therapy*
  • Child
  • Child, Preschool
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Humans
  • Lung / diagnostic imaging*
  • Tomography, X-Ray Computed
  • Treatment Outcome