Pulmonary arteriovenous malformations

Int J Cardiovasc Imaging. 2019 Aug;35(8):1421-1428. doi: 10.1007/s10554-018-1479-x. Epub 2018 Nov 1.

Abstract

Pulmonary arteriovenous malformation, a condition most commonly associated with hereditary hemorrhagic telangiectasia, is an abnormal communication between the pulmonary artery and pulmonary vein without an intervening capillary communication. Although asymptomatic in ~ 50% individuals, it can present with the dreaded complications of stroke or intracranial abscess in high-risk individuals including pregnant women, if untreated. The mainstay of treatment is now endovascular embolization of the feeding artery which can alleviate the symptoms and prevent these complications. In this review, we describe the pathophysiology, methods of screening, diagnostic workup and treatment of these vascular lesions with a particular focus on the currently used embolization techniques and their outcomes.

Keywords: Coil; Embolization; Endovascular therapy; Hereditary hemorrhagic telangiectasia (HHT); Microvascular plug; Pulmonary arteriovenous malformation (PAVM).

Publication types

  • Review

MeSH terms

  • Arteriovenous Malformations / diagnostic imaging
  • Arteriovenous Malformations / epidemiology
  • Arteriovenous Malformations / physiopathology
  • Arteriovenous Malformations / therapy*
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods*
  • Hemodynamics
  • Humans
  • Pulmonary Artery / abnormalities*
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / physiopathology
  • Pulmonary Circulation
  • Pulmonary Veins / abnormalities*
  • Pulmonary Veins / diagnostic imaging
  • Pulmonary Veins / physiopathology
  • Risk Factors
  • Treatment Outcome