British Thoracic Society Clinical Statement on Pulmonary Arteriovenous Malformations.
Author(s)
Type
Journal Article
Abstract
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. The driver for the current Clinical Statement was the plethora of new data since previous hereditary haemorrhagic telangiectasia (HHT) guidelines generated in 2006 and a systematic Cochrane Review for PAVM embolisation in 2011. The British Thoracic Society (BTS) identified key areas in which there is now evidence to drive a change in practice. Due to the paucity of data in children, this Statement focused on adults over 16 years. The Statement spans the management of PAVMs already known to be present (interventional and medical), screening and diagnosis (for PAVMs and HHT) and follow-up of patients following a first diagnosis, intervention or negative screen for PAVMs. The Good Practice Points (in bold) were generated for a target audience of general respiratory, medical and specialist clinicians and were approved by the BTS Standards of Care Committee, before formal peer review and public consultation. The Statement spans embolisation treatment, accessory medical management and issues related to the likelihood of underlying HHT.
Date Issued
2017-11-15
Date Acceptance
2017-09-04
Citation
Thorax, 2017, 72 (12), pp.1154-1163
ISSN
1468-3296
Publisher
BMJ Publishing Group
Start Page
1154
End Page
1163
Journal / Book Title
Thorax
Volume
72
Issue
12
Copyright Statement
BTS arrangement with Thorax for Guidelines and for Clinical Statements is that a copy of the publication can be placed on the BTS website - no restrictions on access
Sponsor
Imperial College Trust
Imperial College Healthcare NHS Trust
Imperial College Healthcare NHS Trust - CLRN Funding
Identifier
PII: thoraxjnl-2017-210764
Grant Number
N/A
None
WHCV_P44377
Subjects
British Thoracic Society
1103 Clinical Sciences
Respiratory System
Publication Status
Published