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 or possibly be victim of a stroke.
Currently there are about 4,000 people in the United Kingdom alone that have pulmonary AVMs. Some estimates place as many as one in three of them having a stroke or brain abscess by the age of 65.
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.
However according to a new study from Imperial College London the research shows that treatment lowers the risk of stroke. All of those involved strongly 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.
Dr. Claire Shovlin, from the National Heart and Lung Institute at Imperial College and lead author of the study said, "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."
Pulmonary AVMs are strongly linked to a genetic condition called Hereditary Haemorrhagic Telgangiectasia (HHT). Most people with HHT seem well and are unaware that they have the condition until it is diagnosed in a family member.
Shovilin goes on to say, "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."
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.
Improved dental hygiene is also important in preventing this medical affliction. Health officials say bacteria from the mouth enter the bloodstream and can pass through pulmonary AVMs and enter the brain.
