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Review
. 2024 Sep 19:11:1449496.
doi: 10.3389/fmed.2024.1449496. eCollection 2024.

Neurological and cardiopulmonary manifestations of pulmonary arteriovenous malformations

Weida Lu  1 , Honggang Dai  2 , Yunyi Li  2 , Xiao Meng  2
Affiliations
Review

Neurological and cardiopulmonary manifestations of pulmonary arteriovenous malformations

Weida Lu et al. Front Med (Lausanne). .

Abstract

Pulmonary arteriovenous malformations (PAVMs) are direct pulmonary artery-to-vein connections without pulmonary capillaries that result in intrapulmonary right-to-left blood shunts. Although most patients with PAVMs may be entirely asymptomatic, PAVMs can induce a series of complications involving the neurological, cardiovascular, and respiratory systems that can lead to catastrophic and often fatal clinical sequelae. In this study we review the available literature and summarize the reported PAVM-related complications among patients with PAVMs. The reviewed studies included observational studies, case studies, prospective studies, and cohort studies, and we provide an overview of PAVM-related neurological and cardiopulmonary manifestations, including stroke, cerebral abscess, transient ischemic attack, cerebral hemorrhage, migraine, seizure, dizziness, cardiac failure, arrhythmia, myocardial infarction, cough, hypoxemia, dyspnea, respiratory failure, hemoptysis, and hemothorax. Identifying and treating PAVMs before the presentation of major complication is important because this can prevent the occurrence of complications and can result in better outcomes. PAVM patients should thus be better evaluated and managed by a multidisciplinary team because they may be in a treatable phase prior to their condition becoming life-threatening.

Keywords: cerebral abscess; hypoxemia; pulmonary arteriovenous malformations; stroke; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The structure of the normal capillary bed and the PAVM.
Figure 2
Figure 2
Cases of a simple and a complex PAVM before and after embolotherapy. (A,B) The simple PAVM was treated with Amplatzer Duct Occluder II (5 × 4 mm). (C,D) The complex PAVM was treated with Amplatzer vascular plug (10 × 7 mm) and Boston scientific interlock coils. (Black arrow, simple PAVM; asterisk, complex PAVMs; white arrowhead, embolotherapy material).
Figure 3
Figure 3
Typical CT appearance of a simple and a complex PAVM. (A) The simple PAVM. (B) The complex PAVMs. (White circle, aneurysmal sac).
See this image and copyright information in PMC

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