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The location of the telanglectases determines the course of treatment for HHT patients. Interventional radiologists treat malformations in the lung and brain using embolization.
Lung – These malformations should be treated, even prior to symptoms appearing, due to their life threatening/disabling nature. Interventional radiologists, vascular experts who treat patients internally using imaging to guide them, can permanently treat lung AVMs using a minimally invasive procedure known as embolization. During this procedure, an interventional radiologist makes a small nick in the skin, inserts a catheter into the femoral vein in the groin and then directs it to the abnormal blood vessels in the lung. Next, Dacron platinum coils are placed in the artery feeding the AVM to permanently block the blood flow to the AVM. Patients should be seen one year after treatment by the interventional radiologist to be sure the AVM has been resolved.
Patients are treated either as an outpatient (single AVM) or as an inpatient (multiple AVMs). Local anesthesia is given.
Brain – Size, structure and location in the brain impact how these AVMs are treated. Surgery, embolization and stereotactic radiosurgery are treatment options that can be used separately or in combination. Decisions about whether to treat and types of treatment should be made by a team including neurovascular neurologist, neurosurgeon, and interventional neuroradiologist.