Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Treat all patients with rare lung disease to prevent stroke, say doctors

05.11.2007
Treatment should be offered to all people with a particular rare lung condition, regardless of whether or not they show symptoms of it, say researchers and doctors behind a new study published today.

The research, published online in the journal Thorax, suggests that all patients with abnormal blood vessels in their lungs known as pulmonary arteriovenous malformations (‘pulmonary AVMs’) might benefit from potentially life-saving treatment to block off the malformed blood vessels.

About 4,000 people in the UK are estimated to have pulmonary AVMs. As many as one in three of them will have a stroke or brain abscess by the age of 65, according to the new research.

Until now, treatment has only been available for small numbers of patients in the UK, because its effectiveness at reducing stroke was not proven and it was widely considered that only those already unwell could benefit from it.

The new study is the first to show that treatment lowers the risk of stroke. The authors - researchers and doctors from Imperial College London and Imperial College Healthcare NHS Trust - believe it is important that treatment is offered to all patients and not just to those who are obviously unwell.

The study reveals that seemingly healthy patients, with one or two pulmonary AVMs, have essentially the same risk of stroke as patients who are obviously unwell and have a number of large pulmonary AVMs.

“Our statistical analysis has shown that it doesn’t matter how sick someone is – a pulmonary AVM patient who is fit and well has the same stroke risk as someone who is on oxygen,” said Dr Claire Shovlin, from the National Heart and Lung Institute at Imperial College and lead author of the study.

Pulmonary AVMs are strongly linked to a genetic condition called Hereditary Haemorrhagic Telgangiectasia (HHT), which affects around 1 in 5,000 people in the UK. Most people with HHT are well and are unaware that they have the condition until it is diagnosed in a family member.

The authors of the new study call for screening for pulmonary AVMs to be given to all those with HHT. They say that doctors must not be complacent about the wellbeing of people with HHT just because they appear to be healthy.

“In other parts of the world, it is recommended that people with HHT should be screened for pulmonary AVMs and offered treatment for them. At the moment, relatively few individuals in the UK receive this sort of management,” added Dr Shovlin.

Pulmonary AVMs are a serious risk to patients because the enlarged blood vessels do not do their job of filtering out small clots or infected material circulating in the blood, thus allowing this material to pass into the brain, potentially causing stroke (clots), or brain abscess (infected material).

Pulmonary AVMs can be treated by a procedure known as embolisation, which is performed under local anaesthesia. The new study shows that this procedure is highly effective at preventing stroke in pulmonary AVM patients. All procedures in the study were carried out by Dr James Jackson, an interventional radiologist at Hammersmith Hospital, which is part of Imperial College Healthcare NHS Trust. Dr Jackson is one of the authors of the new research.

For the pulmonary AVM embolisation, the radiologist passes a fine tube through a blood vessel in the top of the leg and then introduces small metallic coils into the malformed blood vessels. The coils block off the blood supply to the malformed blood vessels and force the blood to flow through healthy blood vessels instead, ensuring that the blood is properly filtered.

“We have shown that healthy individuals with pulmonary AVMs may benefit not only from embolisation, but also from other preventative measures, including improving dental hygiene,” said Dr Shovlin.

Improved dental hygiene is important as bacteria from the mouth enter the bloodstream and can pass through pulmonary AVMs and enter the brain.

The cohort study analysed the medical histories of 219 pulmonary AVM patients seen by Dr Shovlin at Hammersmith Hospital from 1999 to 2005. Researchers looked at a huge range of data about the extent of their condition and their general level of health, including the size and number of malformed blood vessels in the lungs, oxygen levels, blood pressure and smoking history. They then compared the data for those patients who had suffered stroke or brain abscess and those who had not.

This study was funded by the Margaret Straker HHT Memorial Fund and donations by families and friends of British HHT patients.

Laura Galagher | alfa
Further information:
http://thorax.bmj.com/
http://www.imperial.ac.uk

More articles from Health and Medicine:

nachricht Second cause of hidden hearing loss identified
20.02.2017 | Michigan Medicine - University of Michigan

nachricht Prospect for more effective treatment of nerve pain
20.02.2017 | Universität Zürich

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Positrons as a new tool for lithium ion battery research: Holes in the electrode

22.02.2017 | Power and Electrical Engineering

New insights into the information processing of motor neurons

22.02.2017 | Life Sciences

Healthy Hiking in Smart Socks

22.02.2017 | Innovative Products

VideoLinks
B2B-VideoLinks
More VideoLinks >>>