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Executive summary of the 11th HHT international scientific conference

  • Executive Summary
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Abstract

Hereditary hemorrhagic telangiectasia (HHT) is a hereditary condition that results in vascular malformations throughout the body, which have a proclivity to rupture and bleed. HHT has a worldwide incidence of about 1:5000 and approximately 80 % of cases are due to mutations in ENG, ALK1 (aka activin receptor-like kinase 1 or ACVRL1) and SMAD4. Over 200 international clinicians and scientists met at Captiva Island, Florida from June 11–June 14, 2015 to present and discuss the latest research on HHT. 156 abstracts were accepted to the meeting and 60 were selected for oral presentations. The first two sections of this article present summaries of the basic science and clinical talks. Here we have summarized talks covering key themes, focusing on areas of agreement, disagreement, and unanswered questions. The final four sections summarize discussions in the Workshops, which were theme-based topical discussions led by two moderators. We hope this overview will educate as well as inspire those within the field and from outside, who have an interest in the science and treatment of HHT.

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References

  1. Shovlin CL, Hughes JM, Tuddenham EG, Temperley I, Perembelon YF, Scott J, Seidman CE, Seidman JG (1994) A gene for hereditary haemorrhagic telangiectasia maps to chromosome 9q3. Nat Genet 6:205–209

    Article  CAS  PubMed  Google Scholar 

  2. Johnson DW, Berg JN, Baldwin MA, Gallione CJ, Marondel I, Yoon SJ, Stenzel TT, Speer M et al (1996) Mutations in the activin receptor-like kinase 1 gene in hereditary haemorrhagic telangiectasia type 2. Nat Genet 13:189–195

    Article  CAS  PubMed  Google Scholar 

  3. Gallione CJ, Repetto GM, Legius E, Rustgi AK, Schelley SL, Tejpar S, Mitchell G, Drouin E et al (2004) A combined syndrome of juvenile polyposis and hereditary haemorrhagic telangiectasia associated with mutations in MADH4 (SMAD4). Lancet 363:852–859

    Article  CAS  PubMed  Google Scholar 

  4. McDonald J, Damjanovich K, Millson A, Wooderchak W, Chibuk JM, Stevenson DA, Gedge F, Bayrak-Toydemir P (2011) Molecular diagnosis in hereditary hemorrhagic telangiectasia: findings in a series tested simultaneously by sequencing and deletion/duplication analysis. Clin Genet 79:335–344

    Article  CAS  PubMed  Google Scholar 

  5. McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead K, Stevenson DA, Bayrak-Toydemir P (2015) Hereditary hemorrhagic telangiectasia: genetics and molecular diagnostics in a new era. Front Genet 6(1):1–8. doi:10.3389/fgene.2015.00001

  6. Bushby K, Finkel R, Wong B, Barohn R, Campbell C, Comi GP, Connolly AM, Day JW et al (2014) Ataluren treatment of patients with nonsense mutation dystrophinopathy. Muscle Nerve 50(4):477–487

    Article  CAS  PubMed  Google Scholar 

  7. Kerem E, Konstan MW, De Boeck K, Accurso FJ, Sermet-Gaudelus I, Wilschanski M, Elborn JS et al (2014) Ataluren for the treatment of nonsense-mutation cystic fibrosis: a randomised, double-blind, placebo-controlled phase 3 trial. Lancet Respir Med 2(7):539–547

    Article  CAS  PubMed  Google Scholar 

  8. Wooderchak-Donahue W, McDonald J, O’Fallon B, Upton PD, Li W, Roman BL, Young S, Plant P et al (2013) BMP9 mutations cause a vascular anomaly syndrome with phenotypic overlap with hereditary hemorrhagic telangiectasia. Am J Hum Genet 93:1–8

    Article  Google Scholar 

  9. Rigelsky CM, Jennings C, Lehtonen R, Minai OA, Eng C, Aldred MA (2008) BMPR2 mutation in a patient with pulmonary arterial hypertension and suspected hereditary hemorrhagic telangiectasia. Am J Med Genet A 146A(19):2551–2556

    Article  CAS  PubMed  Google Scholar 

  10. Larrivée B, Prahst C, Gordon E, del Toro R, Mathivet T, Duarte A, Simons M, Eichmann A (2012) ALK1 signaling inhibits angiogenesis by cooperating with the Notch pathway. Dev Cell 22(3):489–500

    Article  PubMed Central  PubMed  Google Scholar 

  11. Cartin-Ceba R, Swanson KL, Krowka MJ (2013) Pulmonary arteriovenous malformations. Chest 144:1033–1044

    Article  PubMed  Google Scholar 

  12. Kjeldsen AD, Oxhoj H, Andersen PE, Green A, Vase P (2000) Prevalence of pulmonary arteriovenous malformations (PAVM) and occurrence of neurological symptoms in patients with hereditary haemorrhagic telangiectasia (HHT). J Intern Med 248:255–262

    Article  CAS  PubMed  Google Scholar 

  13. Moussouttas M, Fayad P, Rosenblatt M, Hashimoto M, Pollak J, Henderson K, Ma TY, White RI (2000) Pulmonary arteriovenous malformations: cerebral ischemia and neurologic manifestations. Neurology 55:959–964

    Article  CAS  PubMed  Google Scholar 

  14. Shovlin CL, Jackson JE, Bamford KB, Jenkins IH, Benjamin AR, Ramadan H, Kulinskaya E (2008) Primary determinants of ischaemic stroke/brain abscess risks are independent of severity of pulmonary arteriovenous malformations in hereditary haemorrhagic telangiectasia. Thorax 63:259–266

    Article  CAS  PubMed  Google Scholar 

  15. Velthuis S, Buscarini E, van Gent MW, Gazzaniga P, Manfredi G, Danesino C, Schonewille WJ, Westermann CJ et al (2013) Grade of pulmonary right-to-left shunt on contrast echocardiography and cerebral complications: a striking association. Chest 144:542–548

    Article  PubMed  Google Scholar 

  16. Faughnan ME, Palda VA, Garcia-Tsao G, Geisthoff UW, McDonald J, Proctor DD, Spears J, Brown DH et al (2011) International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet 48:73–87

    Article  CAS  PubMed  Google Scholar 

  17. Velthuis S, Buscarini E, Gossage JR, Snijder RJ, Mager JJ, Post MC (2015) Clinical implications of pulmonary shunting on saline contrast echocardiography. J Am Soc Echocardiogr 28:255–263

    Article  PubMed  Google Scholar 

  18. Elliott JE, Nigam SM, Laurie SS, Beasley KM, Goodman RD, Hawn JA, Gladstone IM, Chesnutt MS, Lovering AT (2013) Prevalence of left heart contrast in healthy, young, asymptomatic humans at rest breathing room air. Respir Physiol Neurobiol 188:71–78

    Article  PubMed  Google Scholar 

  19. Lovering AT, Stickland MK, Amann M, Murphy JC, O’Brien MJ, Hokanson JS, Eldridge MW (2008) Hyperoxia prevents exercise-induced intrapulmonary arteriovenous shunt in healthy humans. J Physiol 586(18):4559–4565

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Li W, Niu B, Henderson K, Northrup V, Pollak JS, Trow T, Fahey J, White RI Jr (2011) Reproducibility of oxygen saturation monitoring during six-minute walk test and exercise stress test in patients with pulmonary arteriovenous malformations associated with hereditary hemorrhagic telangiectasia. Pediatr Cardiol 32:590–594

    Article  CAS  PubMed  Google Scholar 

  21. Faughnan ME, Thabet A, Mei-Zahav M, Colombo M, Maclusky I, Hyland RH, Pugash RA, Chait P, Henderson KJ, White RI (2004) Pulmonary arteriovenous malformations in children: outcomes of transcatheter embolotherapy. J Pediatr 145:826–831

    Article  PubMed  Google Scholar 

  22. Galiè N, Hoeper MM, Humbert M, Torbicki A, Vachiery JL, Barbera JA, Beghetti M, Corris P et al (2009) Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT). Eur Heart J 30:2493–2537

    Article  PubMed  Google Scholar 

  23. Arthur HM, Ure J, Smith AJ, Renforth G, Wilson DI, Torsney E, Charlton R, Parums DV et al (2000) Endoglin, an ancillary TGFbeta receptor, is required for extraembryonic angiogenesis and plays a key role in heart development. Dev Biol 217:42–53

    Article  CAS  PubMed  Google Scholar 

  24. Bourdeau A, Dumont DJ, Letarte M (1999) A murine model of hereditary hemorrhagic telangiectasia. J Clin Invest 104:1343–1351

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Mahmoud M, Allinson KR, Zhai Z, Oakenfull R, Ghandi P, Adams RH, Fruttiger M, Arthur HM (2010) Pathogenesis of arteriovenous malformations in the absence of endoglin. Circ Res 106:1425–1433

    Article  CAS  PubMed  Google Scholar 

  26. Oh SP, Seki T, Goss KA, Imamura T, Yi Y, Donahoe PK, Li L, Miyazono K et al (2000) Activin receptor-like kinase 1 modulates transforming growth factor-b1 signaling in the regulation of angiogenesis. Proc Natl Acad Sci USA 97:2626–2631

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Park SO, Lee YJ, Seki T, Hong KH, Fliess N, Jiang Z, Park A, Wu X et al (2008) ALK5- and TGFBR2-independent role of ALK1 in the pathogenesis of hereditary hemorrhagic telangiectasia type 2. Blood 111:633–642

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. Park SO, Wankhede M, Lee YJ, Choi EJ, Fliess N, Choe SW, Oh SH, Walter G et al (2009) Real-time imaging of de novo arteriovenous malformation in a mouse model of hereditary hemorrhagic telangiectasia. J Clin Invest 119:3487–3496

    PubMed Central  CAS  PubMed  Google Scholar 

  29. Roman BL, Pham VN, Lawson ND, Kulik M, Childs S, Lekven AC, Garrity DM, Moon RT et al (2002) Disruption of acvrl1 increases endothelial cell number in zebrafish cranial vessels. Development 129:3009–3019

    CAS  PubMed  Google Scholar 

  30. Srinivasan S, Hanes MA, Dickens T, Porteous ME, Oh SP, Hale LP, Marchuk DA (2003) A mouse model for hereditary hemorrhagic telangiectasia (HHT) type 2. Hum Mol Genet 12:473–482

    Article  CAS  PubMed  Google Scholar 

  31. Urness LD, Sorensen LK, Li DY (2000) Arteriovenous malformations in mice lacking activin receptor-like kinase-1. Nat Genet 26:328–331

    Article  CAS  PubMed  Google Scholar 

  32. Bourdeau A, Cymerman U, Paquet ME, Meschino W, McKinnon WC, Guttmacher AE, Becker L, Letarte M (2000) Endoglin expression is reduced in normal vessels but still detectable in arteriovenous malformations of patients with hereditary hemorrhagic telangiectasia type 1. Am J Pathol 156:911–923

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  33. Hawinkels LJ, Kuiper P, Wiercinska E, Verspaget HW, Liu Z, Pardali E, Sier CF, ten Dijke P (2010) Matrix metalloproteinase-14 (MT1–MMP)-mediated endoglin shedding inhibits tumor angiogenesis. Cancer Res 70:4141–4150

    Article  CAS  PubMed  Google Scholar 

  34. Valbuena-Diez AC, Blanco FJ, Oujo B, Langa C, Gonzalez-Nunez M, Llano E, Pendas AM, Diaz M et al (2012) Oxysterol-induced soluble endoglin release and its involvement in hypertension. Circulation 126:2612–2624

    Article  CAS  PubMed  Google Scholar 

  35. Mallet C, Lamribet K, Giraud S, Dupuis-Girod S, Feige JJ, Bailly S, Tillet E (2014) Functional analysis of endoglin mutations from hereditary hemorrhagic telangiectasia type 1 patients reveals different mechanisms for endoglin loss of function. Hum Mol Genet 24(4):1142–1154

    Article  PubMed  Google Scholar 

  36. Corti P, Young S, Chen CY, Patrick MJ, Rochon ER, Pekkan K, Roman BL (2011) Interaction between alk1 and blood flow in the development of arteriovenous malformations. Development 138:1573–1582

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  37. Choi EJ, Walker EJ, Shen F, Oh SP, Arthur HM, Young WL, Su H (2012) Minimal homozygous endothelial deletion of Eng with VEGF stimulation is sufficient to cause cerebrovascular dysplasia in the adult mouse. Cerebrovasc Dis 33:540–547

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  38. Garrido-Martin EM, Nguyen HL, Cunningham TA, Choe SW, Jiang Z, Arthur HM, Lee YJ, Oh SP (2014) Common and distinctive pathogenetic features of arteriovenous malformations in hereditary hemorrhagic telangiectasia 1 and hereditary hemorrhagic telangiectasia 2 animal models—brief report. Arterioscler Thromb Vasc Biol 34:2232–2236

    Article  CAS  PubMed  Google Scholar 

  39. Han C, Choe SW, Kim YH, Acharya AP, Keselowsky BG, Sorg BS, Lee YJ, Oh SP (2014) VEGF neutralization can prevent and normalize arteriovenous malformations in an animal model for hereditary hemorrhagic telangiectasia 2. Angiogenesis 17:823–830

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Hao Q, Zhu Y, Su H, Shen F, Yang GY, Kim H, Young WL (2010) VEGF induces more severe cerebrovascular dysplasia in endoglin than in alk1 mice. Transl Stroke Res 1:197–201

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  41. Walker EJ, Su H, Shen F, Choi EJ, Oh SP, Chen G, Lawton MT, Kim H et al (2011) Arteriovenous malformation in the adult mouse brain resembling the human disease. Ann Neurol 69:954–962

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  42. Bayrak-Toydemir P, McDonald J, Markewitz B, Lewin S, Miller F, Chou LS, Gedge F, Tang W et al (2006) Genotype–phenotype correlation in hereditary hemorrhagic telangiectasia: mutations and manifestations. Am J Med Genet A 140(5):463–470

    Article  PubMed  Google Scholar 

  43. Berg J, Porteous M, Reinhardt D, Gallione C, Holloway S, Umasunthar T, Lux A, McKinnon W et al (2003) Hereditary haemorrhagic telangiectasia: a questionnaire based study to delineate the different phenotypes caused by endoglin and ALK1 mutations. J Med Genet 40(8):585–590

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  44. Kjeldsen AD, Møller TR, Brusgaard K, Vase P, Andersen PE (2005) Clinical symptoms according to genotype amongst patients with hereditary haemorrhagic telangiectasia. J Intern Med 258(4):349–355

    Article  CAS  PubMed  Google Scholar 

  45. Letteboer TG, Mager HJ, Snijder RJ, Lindhout D, Ploos van Amstel HK, Zanen P, Westermann KJ (2008) Genotype–phenotype relationship for localization and age distribution of telangiectases in hereditary hemorrhagic telangiectasia. Am J Med Genet A 146A(21):2733–2739

    Article  PubMed  Google Scholar 

  46. Letteboer TG, Mager JJ, Snijder RJ, Koeleman BP, Lindhout D, Ploos van Amstel JK, Westermann CJ (2006) Genotype–phenotype relationship in hereditary haemorrhagic telangiectasia. J Med Genet 43(4):371–377

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  47. Shovlin CL (2010) Hereditary haemorrhagic telangiectasia: pathophysiology, diagnosis and treatment. Blood Rev 24(6):203–219

    Article  CAS  PubMed  Google Scholar 

  48. Wever-Pinzon O, Selzman CH, Drakos SG, Saidi A, Stoddard GJ, Gilbert EM, Labedi M, Reid BB et al (2013) Pulsatility and the risk of nonsurgical bleeding in patients supported with the continuous-flow left ventricular assist device HeartMate II. Circ Heart Fail 6(3):517–526

    Article  CAS  PubMed  Google Scholar 

  49. Tual-Chalot S, Mahmoud M, Allinson KR, Redgrave RE, Zhai Z, Oh SP, Fruttiger M, Arthur HM (2014) Endothelial depletion of Acvrl1 in mice leads to arteriovenous malformations associated with reduced endoglin expression. PLoS ONE 9(6):e98646

    Article  PubMed Central  PubMed  Google Scholar 

  50. Yoshimatsu Y, Lee YG, Akatsu Y, Taguchi L, Suzuki HI, Cunha SI, Maruyama K, Suzuki Y (2013) Bone morphogenetic protein-9 inhibits lymphatic vessel formation via activin receptor-like kinase 1 during development and cancer progression. Proc Natl Acad Sci USA 110(47):18940–18945

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  51. Gaillard S, Dupuis-Girod S, Boutitie F, Riviere S, Moriniere S, Hatron PY, Manfredi G, Kaminsky P et al (2014) Tranexamic acid for epistaxis in hereditary hemorrhagic telangiectasia patients: a European cross-over controlled trial in a rare disease. J Thromb Haemost 12:1494–1502

    Article  CAS  PubMed  Google Scholar 

  52. Geisthoff UW, Seyfert UT, Kubler M, Bieg B, Plinkert PK, Konig J (2014) Treatment of epistaxis in hereditary hemorrhagic telangiectasia with tranexamic acid—a double-blind placebo-controlled cross-over phase IIIB study. Thromb Res 134:565–571

    Article  CAS  PubMed  Google Scholar 

  53. Cirulli A, Liso A, D’Ovidio F, Mestice A, Pasculli G, Gallitelli M, Rizzi R, Specchia G, Sabba C (2003) Vascular endothelial growth factor serum levels are elevated in patients with hereditary hemorrhagic telangiectasia. Acta Haematol 110:29–32

    Article  CAS  PubMed  Google Scholar 

  54. Dupuis-Girod S, Ginon I, Saurin JC, Marion D, Guillot E, Decullier E, Roux A, Carette MF et al (2012) Bevacizumab in patients with hereditary hemorrhagic telangiectasia and severe hepatic vascular malformations and high cardiac output. JAMA 307:948–955

    Article  CAS  PubMed  Google Scholar 

  55. Thompson AB, Ross DA, Berard P, Figueroa-Bodine J, Livada N, Richer SL (2014) Very low dose bevacizumab for the treatment of epistaxis in patients with hereditary hemorrhagic telangiectasia. Allergy Rhinol 5:e91–e95. doi:10.2500/ar.2014.5.0091

    Article  Google Scholar 

  56. Riss D, Burian M, Wolf A, Kranebitter V, Kaider A, Arnoldner C (2015) Intranasal submucosal bevacizumab for epistaxis in hereditary hemorrhagic telangiectasia: a double-blind, randomized, placebo-controlled trial. Head Neck 37(6):783–787

    Article  PubMed  Google Scholar 

  57. Dupuis-Girod S, Ambrun A, Decullier E, Samson G, Roux A, Fargeton AE, Rioufol C, Schwiertz V et al (2014) ELLIPSE Study: a Phase 1 study evaluating the tolerance of bevacizumab nasal spray in the treatment of epistaxis in hereditary hemorrhagic telangiectasia. MAbs 6:794–799

    Article  PubMed  Google Scholar 

  58. Lebrin F, Srun S, Raymond K, Martin S, van den Brink S, Freitas C, Breant C, Mathivet T et al (2010) Thalidomide stimulates vessel maturation and reduces epistaxis in individuals with hereditary hemorrhagic telangiectasia. Nat Med 16:420–428

    Article  CAS  PubMed  Google Scholar 

  59. Jameson JJ, Cave DR (2004) Hormonal and antihormonal therapy for epistaxis in hereditary hemorrhagic telangiectasia. Laryngoscope 114:705–709

    Article  PubMed  Google Scholar 

  60. Van Cutsem E, Rutgeerts P, Vantrappen G (1990) Treatment of bleeding gastrointestinal vascular malformations with oestrogen-progesterone. Lancet 335:953–955

    Article  PubMed  Google Scholar 

  61. Vase P (1981) Estrogen treatment of hereditary hemorrhagic telangiectasia. A double-blind controlled clinical trial. Acta Med Scand 209:393–396

    Article  CAS  PubMed  Google Scholar 

  62. Bergler W, Sadick H, Gotte K, Riedel F, Hormann K (2002) Topical estrogens combined with argon plasma coagulation in the management of epistaxis in hereditary hemorrhagic telangiectasia. Ann Otol Rhinol Laryngol 111:222–228

    Article  PubMed  Google Scholar 

  63. Yaniv E, Preis M, Hadar T, Shvero J, Haddad M (2009) Antiestrogen therapy for hereditary hemorrhagic telangiectasia: a double-blind placebo-controlled clinical trial. Laryngoscope 119:284–288

    Article  CAS  PubMed  Google Scholar 

  64. AlbinanaV Bernabeu-Herrero ME, Zarrabeitia R, Bernabeu C, Botella LM (2010) Estrogen therapy for hereditary haemorrhagic telangiectasia (HHT): effects of raloxifene, on endoglin and ALK1 expression in endothelial cells. Thromb Haemost 103:525–534

    Article  Google Scholar 

  65. Bjelakovic B, Bojanovic M, Lukic S, Saranac L, Vukomanovic V, Prijic S, Zivkovic N, Randjelovic D (2013) The therapeutic efficacy of propranolol in children with recurrent primary epistaxis. Drug Des Devel Ther 7:127–129

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  66. de Gussem EM, Snijder RJ, Disch FJ, Zanen P, Westermann CJ, Mager JJ (2009) The effect of N-acetylcysteine on epistaxis and quality of life in patients with HHT: a pilot study. Rhinology 47:85–88

    PubMed  Google Scholar 

  67. Reh DD, Hur K, Merlo CA (2013) Efficacy of a topical sesame/rose geranium oil compound in patients with hereditary hemorrhagic telangiectasia associated epistaxis. Laryngoscope 123:820–822

    Article  CAS  PubMed  Google Scholar 

  68. Faughnan ME, Lui YW, Wirth JA, Pugash RA, Redelmeier DA, Hyland RH, White RI (2000) Diffuse pulmonary arteriovenous malformations: characteristics and prognosis. Chest 117:31–38

    Article  CAS  PubMed  Google Scholar 

  69. Lacombe P, Lacout A, Marcy PY, Binsse S, Sellier J, Bensalah M, Chinet T, Bourgault-Villada I et al (2013) Diagnosis and treatment of pulmonary arteriovenous malformations in hereditary hemorrhagic telangiectasia: an overview. Diagn Interv Imaging 94:835–848

    Article  CAS  PubMed  Google Scholar 

  70. Lacombe P, Lagrange C, El Hajjam M, Chinet T, Pelage JP (2005) Reperfusion of complex pulmonary arteriovenous malformations after embolization: report of three cases. Cardiovasc Intervent Radiol 28:30–35

    Article  PubMed  Google Scholar 

  71. Milic A, Chan RP, Cohen JH, Faughnan ME (2005) Reperfusion of pulmonary arteriovenous malformations after embolotherapy. J Vasc Interv Radiol 16:1675–1683

    Article  PubMed  Google Scholar 

  72. Pollak JS, Saluja S, Thabet A, Henderson KJ, Denbow N, White RI (2006) Clinical and anatomic outcomes after embolotherapy of pulmonary arteriovenous malformations. J Vasc Interv Radiol 17:35–45

    Article  PubMed  Google Scholar 

  73. Brillet PY, Dumont P, Bouaziz N, Duhamel A, Laurent F, Remy J, Remy-Jardin M (2007) Pulmonary arteriovenous malformation treated with embolotherapy: systemic collateral supply at multidetector CT angiography after 2–20-year follow-up. Radiology 242:267–276

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to acknowledge the financial support of Cure HHT and the scientific contributions of the attendees that made this meeting possible.

Funding

This conference was supported by Cure HHT, HHT Ireland, Covidien, Medtronic, ARUP Laboratories, Genetic Diagnostic Laboratory, Boston Scientific, Actelion, Ambry Genetics, Gilead, B. Braun GeGaT, and St. Jude Medical.

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Correspondence to James R. Gossage.

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Conflict of interest

J. Gossage is a part time paid Medical Director of Cure HHT; C. Hughes was reimbursed for meeting expenses by Cure HHT; the other authors report no conflicts.

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Arthur, H., Geisthoff, U., Gossage, J.R. et al. Executive summary of the 11th HHT international scientific conference. Angiogenesis 18, 511–524 (2015). https://doi.org/10.1007/s10456-015-9482-5

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