Procedural descriptions and survival times for hepatic arteriovenous malformations (HAVM) in animals receiving primarily conservative treatment, arterial embolization, or dominant outflow vein occlusion
🔍 Key Findings
- Surgical management significantly improves survival vs medical therapy, with MST ~1942d vs 567d (p = .028), supporting intervention over conservative care.
- DOV occlusion achieves superior initial occlusion rates (95% vs 56% for TAE; p = .007), making it more reliable for immediate flow cessation.
- TAE has significantly higher recurrence rates (53% vs 15% for DOV; p < .001), often requiring repeat procedures.
- Residual HAVM flow is more common after TAE (44% vs 5%), reflecting difficulty targeting the nidus via arterial routes.
- Overall survival time between TAE and DOV is not significantly different, but more DOV patients remain alive at follow-up (55% vs 11%; p = .003).
- Quality of life outcomes favor DOV, with 78% “excellent” vs 27% in TAE (p = .018).
- Multiple arterial supply sources (e.g., gastric, phrenic, intercostal arteries) complicate complete embolization and contribute to recurrence (Figure 6, page 17).
- Restoration of hepatopetal portal flow is a key success indicator, particularly after DOV occlusion (page 16 discussion).
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🔍 Key Findings
- Surgical management significantly improves survival vs medical therapy, with MST ~1942d vs 567d (p = .028), supporting intervention over conservative care.
- DOV occlusion achieves superior initial occlusion rates (95% vs 56% for TAE; p = .007), making it more reliable for immediate flow cessation.
- TAE has significantly higher recurrence rates (53% vs 15% for DOV; p < .001), often requiring repeat procedures.
- Residual HAVM flow is more common after TAE (44% vs 5%), reflecting difficulty targeting the nidus via arterial routes.
- Overall survival time between TAE and DOV is not significantly different, but more DOV patients remain alive at follow-up (55% vs 11%; p = .003).
- Quality of life outcomes favor DOV, with 78% “excellent” vs 27% in TAE (p = .018).
- Multiple arterial supply sources (e.g., gastric, phrenic, intercostal arteries) complicate complete embolization and contribute to recurrence (Figure 6, page 17).
- Restoration of hepatopetal portal flow is a key success indicator, particularly after DOV occlusion (page 16 discussion).
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