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Clinical Investigations: PREGNANCY |

Transcatheter Embolotherapy of Maternal Pulmonary Arteriovenous Malformations During Pregnancy*

Andrea S. Gershon, MD; Marie E. Faughnan, MD; Kenneth S. Chon, MD; Robyn A. Pugash, MD; John A. Clark, MD, CM; Michael J. Bohan, BS; Katherine J. Henderson, MS; Robert H. Hyland, MD, FCCP; Robert I. White, Jr., MD
Author and Funding Information

*From the Departments of Medicine (Drs. Gershon, Faughnan, and Hyland) and Medical Imaging (Drs. Pugash and Clark), St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada; and Department of Diagnostic Imaging (Drs. Chon and White, Mr. Bohan, and Ms. Henderson), Yale University School of Medicine, New Haven, CT.

Correspondence to: Marie E. Faughnan, MD, St. Michael’s Hospital, 30 Bond St, Toronto, Ontario M5B 1W8, Canada; e-mail: hylandb@smh.toronto.on.ca



Chest. 2001;119(2):470-477. doi:10.1378/chest.119.2.470
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Study objectives: To determine if transcatheter embolotherapy is safe and effective for the treatment of pulmonary arteriovenous malformations during pregnancy.

Design: Prospective study.

Setting: Specialized hereditary hemorrhagic telangiectasia centers at Yale University School of Medicine and St. Michael’s Hospital, University of Toronto.

Patients: Seven pregnant women (age range, 24 to 34 years; gestational age range, 16 to 36 weeks) undergoing transcatheter embolotherapy.

Interventions: Transcatheter embolotherapy in all patients.

Measurements and results: Thirteen pulmonary arteriovenous malformations in seven patients were embolized with detachable silicone balloons and/or stainless steel coils without incident. The estimated fetal radiation dose ranged from < 50 to 220 mrad. No complications of pulmonary arteriovenous malformations occurred in any of the patients after transcatheter embolotherapy. The mothers went on to deliver healthy babies in all cases.

Conclusions: Transcatheter embolotherapy of maternal pulmonary arteriovenous malformations performed by an experienced radiologist appears to be safe and effective after 16 weeks of gestational age.


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