Procedural descriptions and survival times for hepatic arteriovenous malformations (HAVM) in animals receiving primarily conservative treatment, arterial embolization, or dominant outflow vein occlusion.

Abstract

OBJECTIVE: Hepatic arteriovenous malformations (HAVM) are complex congenital vascular anomalies associated with liver dysfunction. Due to surgical morbidity, alternative treatments including medical management, transarterial glue embolization (TAE), and dominant outflow vein (DOV) occlusion have been pursued. The goal of this study was to compare outcomes in terms of patient survival following medical and surgical techniques. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: A total of 46 client-owned animals. METHODS: Medical records from an Interventional Radiology (IR) service were reviewed for all HAVM patients treated over a 20-year period. Information collected included patient signalment, presenting clinical signs, diagnostic imaging and biochemical findings, medical, surgical/interventional managements pursued with associated complications, and patient outcomes including medication requirements and median survival times (MST). Patients were excluded from the study if final follow-up information was less than 1 year. RESULTS: A total of 43 dogs and three cats were identified. In dogs, medical management alone in four animals yielded a MST of 567 days (d) while surgery provided a MST of 1942d. While surgical complications and MST were not significantly different between the surgical treatment groups, the TAE group was significantly more likely to have remaining HAVM blood flow immediately after treatment (44% vs. 5%) and experience HAVM recurrence (53% vs. 15%) prompting additional treatments compared to the DOV group. CONCLUSION: Patients with HAVM may have improved outcomes following surgical treatment. TAE and DOV occlusion have similar overall outcomes but different recurrence rates. CLINICAL IMPACT: Surgical management of HAVM can be safe and effective. The advantages of individual techniques require further investigation.