Review for 10.1186/s12876-016-0485-5 (2016)

Reviewer ’s report  
 
Title: Thrombosis of Pancreatic Arteriovenous Malfo rmation Induced by Diagnostic  
Angiography:  Case Report  
 
Version: 0 Date: 01 Feb 2016  
 
Reviewer: Riccardo Robertis  
 
Reviewer's report:  
Dear Authors  
I have read your paper entitled "Spontaneous angiographic thrombosis of pancreatic 
arteriovenous malformation: case report" (manuscript n° BMGE -D-15-00226).  
Your paper describes a case of pancreatic AVM "spontaneously" thrombosed after diagnostic 
angiography. The patient had acute pancreatitis after DSA. Good DSA, US, MRI and CT images 
are provided.  
This case is interesting because it suggests that the angiog raphic treatment of pancreatic AVMs 
can result in severe complications as (ischemic) acute pancreatitis. You should therefore 
emphasize this point, focusing on possible complications of DSA in the setting of  pancreatic 
AVMs. The final message should be th at pancreatic AVM, when asymptomatic and correctly 
diagnosed with non -invasive imaging techniques, should not be evaluated with DSA, considered 
the potential risk of severe complications.  
 
See below for further specific comments:  
- This is not a spontaneou s thrombosis: it is iatrogenic.  
- Treatment of pancreatic AVMs is indicated only in symptomatic patients, which are the 
minority: please emphasize this aspect.  
- Physiopathology: low flow dynamics of the small caliber PAVM and local administration of 
contr ast medium may represent risk factors for PAVM thrombosis; consider also the 
possibility of vessel damage during superselective characterization. Why did you exclude this 
possibility?  
- Be careful: this is not an interstitial pancreatitis. Figure 3 shows a n area of intra -parenchymal 
necrosis (necrotising pancreatitis).  
- Diagnostic angiography: please provide more details regarding the equipment used (which 
catheters/guidewires, total amount of contrast medium)  
- Post-angiography follow -up: which therapy f or acute pancreatitis after angiography?  
- Some grammar errors throughout the text.  
 
Kind regards  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing inte rests, considering the following questions:  
1. Have yo u in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
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3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
4. Have you received reimbu rsements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
5. Do you have any other financial competing interests?  
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