Clinical characteristics of pulmonary arteriovenous malformations in Koreans

Background and objectiveAlthough pulmonary arteriovenous malformations (PAVMs) are rare, they are important in clinical practice because they are associated with life-threatening complications such as brain abscess, stroke and lung haemorrhage. The aims of the present study were to characterize PAVMs in a Korean population and to examine the incidence and factors associated with cerebral complications, which are a major cause of mortality. MethodsThe medical records of patients with PAVMs between 2000 and 2013 were retrospectively reviewed. PAVMs were confirmed by enhanced chest computed tomography or by pulmonary angiography. ResultsNinety patients (median age, 47.5 years; 81.8% female) with PAVMs were included. Twelve patients (13.3%) were clinically diagnosed with hereditary haemorrhagic telangiectasia (HHT) according to the Curacao criteria. Sixty-three patients underwent transcatheter embolization with no severe adverse events. Three patients required retreatment during a mean follow-up period of 3.3 years. Six and 14 patients suffered brain abscess or stroke, respectively, as a complication of PAVMs. These complications were not associated with the diameter of the arteries feeding the PAVMs (odds ratio, 1.106; 95% confidence interval, 0.895-1.366; P=0.352) ConclusionsPAVMs are less associated with HHT in Koreans than in Western populations. Transcatheter embolization of PAVMs is safe and effective, and physicians need to consider treating the small arteries feeding PAVMs to prevent cerebral complications. This study represents the first survey of pulmonary arteriovenous malformations (PAVMs) in Koreans. The results show that PAVMs were less associated with hereditary haemorrhagic telangiectasia in the Korean population than in Western populations and that treatment of PAVMs with small-diameter feeding vessels should be considered to prevent cerebral complications.