title: Screening for arteriovenous malformations in hereditary haemorrhagic telangiectasia.
abstract: OBJECTIVE
  To determine whether patients with hereditary haemorrhagic telangiectasia were being screened according to international guidelines, and to review recent evidence in order to provide up-to-date guidelines for the initial systemic management of hereditary haemorrhagic telangiectasia.
  
  
  METHODS
  A retrospective case note analysis was conducted, assessing patients in terms of screening for: genetics, cerebral arteriovenous malformations, pulmonary and hepatic arteriovenous malformations, and gastrointestinal telangiectasia. Databases searched included Medline, the Cumulative Index to Nursing and Allied Health Literature, and Embase.
  
  
  RESULTS
  Screening investigations were most frequently performed for hepatic arteriovenous malformations and least frequently for genetics. Recent data suggest avoiding routine genetic and cerebral arteriovenous malformation screening because of treatment morbidities; performing high-resolution chest computed tomography for pulmonary arteriovenous malformation screening; using capsule endoscopy (if possible) to reduce complications from upper gastrointestinal endoscopy; and omitting routine liver enzyme testing in favour of Doppler ultrasound.
  
  
  CONCLUSIONS
  Opportunities for systemic arteriovenous malformation screening are frequently overlooked. This review highlights the need for screening and considers the form in which it should be undertaken.
authors.affiliation: ENT Department,Princess Royal Hospital,Shrewsbury and Telford Hospital NHS Trust,Telford,UK.
authors.forename: S
authors.initials: S
authors.lastname: Jervis
authors.affiliation: ENT Department,Princess Royal Hospital,Shrewsbury and Telford Hospital NHS Trust,Telford,UK.
authors.forename: D
authors.initials: D
authors.lastname: Skinner
mesh_terms: D004739:England; D005820:Genetic Testing / Q000706:statistics & numerical data*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D008403:Mass Screening / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications* / Q000235:genetics
keywords: Arteriovenous Malformation; Guidelines; Hereditary Hemorrhagic Telangiectasia; Screening; Treatment