RADIOTHERAPY & SURGERY
If a family history of pulmonary, hepatic, or cerebral arteriovenous malformations exists, screening at puberty and at the end of adolescence with pulmonary CT, hepatic CT, and cerebral MRI is recommended.
Possible HHT Treatments:
- Sometimes laser ablation, surgical resection, or embolization of symptomatic arteriovenous malformations
- Supplemental iron therapy
- Possibly blood transfusions
- Sometimes antifibrinolytic drugs (eg, aminocaproic acid, tranexamic acid)
Treatment for most patients is supportive, but accessible telangiectasias (eg, in the nose or GI tract via endoscopy) may be treated with laser ablation. Arteriovenous fistulas may be treated by surgical resection or embolization. Repeated blood transfusions may be needed; therefore, immunization with hepatitis B vaccine is important. Many patients require continuous iron therapy to replace iron lost in repeated mucosal bleeding; many patients require parenteral iron and sometimes erythropoietin (see Iron Deficiency Anemia). Treatment with drugs that inhibit fibrinolysis, such as aminocaproic acid or tranexamic acid may be beneficial.