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. 2010 Sep 28;2(9):339-44.
doi: 10.4329/wjr.v2.i9.339.

Interventional treatment of pulmonary arteriovenous malformations

Poul Erik Andersen  1 , Anette Drøhse Kjeldsen
Affiliations

Interventional treatment of pulmonary arteriovenous malformations

Poul Erik Andersen et al. World J Radiol. .

Abstract

Pulmonary arteriovenous malformations (PAVM) are congenital vascular communications in the lungs. They act as right to left shunts so that the blood running through these malformations is not oxygenated or filtered. These patients are typically hypoxaemic with exercise intolerance and are at high risk of paradoxical emboli to the brain and other organs. These malformations are most commonly seen in hereditary haemorrhagic telangiectasia (HHT) (Mb. Osler-Weber-Rendu syndrome). Nowadays, the generally accepted treatment strategy of first choice is embolization of the afferent arteries to the arteriovenous malformations. It is a minimally invasive procedure and at the same time a lung preserving treatment with a very high technical success, high effectiveness and low morbidity and mortality. Embolization prevents cerebral stroke and abscess as well as pulmonary haemorrhage and further raises the functional level. Embolization is a well-established method of treating PAVM, with a significant effect on oxygenation of the blood. Screening for PAVM in patients at risk is recommended, especially in patients with HHT.

Keywords: Embolization; Hereditary hemorrhagic; Interventional; Pulmonary artery; Pulmonary circulation; Radiology; Telangiectasia.

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Figures

Figure 1
Figure 1
Simple pulmonary arteriovenous malformations with one afferent (feeding) artery and one efferent (draining) vein. PAVM: Pulmonary arteriovenous malformations.
Figure 2
Figure 2
Complex pulmonary arteriovenous malformations. A: Two afferent (feeding) arteries (arrows); B: After embolization with balloon in one feeding artery (arrows) and coils in the other.
Figure 3
Figure 3
Multiple pulmonary arteriovenous malformations. A: In both lungs; B: Multiple pulmonary arteriovenous malformations (PAVM) after embolization. One small PAVM on the right side has been left untreated because of small sized feeding artery (arrow).
Figure 4
Figure 4
Pulmonary arteriovenous malformations in both lungs, visible on the chest X-ray.
Figure 5
Figure 5
Computed tomography of the chest showing pulmonary arteriovenous malformations with afferent and efferent vessels.
Figure 6
Figure 6
Simple pulmonary arteriovenous malformations. A, B: Before embolization; C: After selective catheterization of the feeding artery; D: After embolization with coils (arrow).
Figure 7
Figure 7
Embolization of simple pulmonary arteriovenous malformations with vascular plug.
Figure 8
Figure 8
One version of a vascular plug.
See this image and copyright information in PMC

References

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