Smoking May Limit Success of Embolization Therapy for PAVMs
WEDNESDAY, July 31, 2019 -- For patients with hereditary hemorrhagic telangiectasia (HHT), the rates of pulmonary arteriovenous malformation (PAVM) persistence after pulmonary embolization are increased with active tobacco use, according to a study published online July 30 in Radiology.
Mustafa M. Haddad, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues retrospectively identified patients with HHT treated for PAVMs between January 2000 and August 2017. Risk factors for PAVM persistence after embolization were determined in a multivariate model.
The researchers found that the five-year cumulative incidence of persistence was 12.2, 21.9, and 37.8 percent, respectively, for nonsmokers, smokers of one to 20 pack-years, and smokers of more than 20 pack-years. Compared with nonsmokers, smokers with more than 20 pack-years had a greater risk for persistence after adjustment for arterial feeder size (hazard ratio, 3.8). The five-year cumulative probability of persistence was 26.3 percent for patients who reported active tobacco use at the time of PAVM embolization compared with 13.5 percent in inactive smokers. The risk for persistence was greater in tobacco users versus inactive smokers at the time of treatment after adjustment for arterial feeder size (hazard ratio, 2.4).
"Smoking is a potentially modifiable risk factor for PAVM embolization persistence in patients with HHT after embolotherapy," the authors write. "These findings, if confirmed in larger studies, raise the possibility that smoking has an important role in persistence in patients with HHT."
One author disclosed financial ties to Flexstent.
© 2020 HealthDay. All rights reserved.
Posted: July 2019
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