Renal Sympathetic-Nerve Ablation for Uncontrolled Hypertension

evidence of the efficacy of bevacizumab in patients with HHT. Both cases also show that symptoms and transfusion requirements improve with this therapy, without an appreciable change in arteriovenous malformations. Like Oosting et al., we found no difference in the size of our patient's pulmonary arteriovenous malformations on CT before and after bevacizumab. Their experience demonstrates the long-term safety and tolerability of bevacizumab in such patients. Our patient continues to report symptomatic benefit more than a year after completing therapy, and he has required only one intravenous infusion of iron during this time. His hemoglobin levels have remained stable at 14 to 15 g per deciliter. The cost of our patient's regimen (a total of 30 mg per kilogram over four cycles) would be approximately $12,000 today. The costs of continuing the drug in the long term, especially without a Food and Drug Administration-approved indication, would be prohibitive. Our case shows that intermittent dosing allows for long-term, symptomatic improvement and stability of pulmonary arteriovenous malformations.