title: Pulmonary arteriovenous malformations in children: outcomes of transcatheter embolotherapy.
abstract: OBJECTIVE
  To describe outcomes of transcatheter embolotherapy (TCE) in children with pulmonary arteriovenous malformations (PAVMs).
  
  
  METHODS
  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.
authors.affiliation: Department of Medicine, Division of Respiratory Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. faughnanm@smh.toronto.on.ca
authors.forename: Marie E
authors.initials: ME
authors.lastname: Faughnan
authors.forename: Ashraf
authors.initials: A
authors.lastname: Thabet
authors.forename: Meir
authors.initials: M
authors.lastname: Mei-Zahav
authors.forename: Maria
authors.initials: M
authors.lastname: Colombo
authors.forename: Ian
authors.initials: I
authors.lastname: Maclusky
authors.forename: Robert H
authors.initials: RH
authors.lastname: Hyland
authors.forename: Robyn A
authors.initials: RA
authors.lastname: Pugash
authors.forename: Peter
authors.initials: P
authors.lastname: Chait
authors.forename: Katharine J
authors.initials: KJ
authors.lastname: Henderson
authors.forename: Robert I
authors.initials: RI
authors.lastname: White
mesh_terms: D000293:Adolescent; D001165:Arteriovenous Malformations / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome