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Pulmonary Embolism I: Introduction

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...

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Updated: Jul 4, 2026

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Pulmonary arteriovenous malformations: how do I embolize?

Robert I White¹

¹Yale Vascular Malformation Center, Yale University School of Medicine, New Haven, CT 06520, USA. bob.white@yale.edu

Techniques in Vascular and Interventional Radiology

|June 24, 2008

Summary

Pulmonary arteriovenous malformations (PAVMs) are vascular defects that can cause stroke and other serious complications. Precise coil embolization techniques offer a safe and effective treatment, with a low recurrence rate.

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Area of Science:

Vascular Surgery
Interventional Radiology
Genetics

Background:

Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary arteries and veins, bypassing capillaries.
PAVMs lead to right-to-left shunting, causing hypoxemia and symptoms like dyspnea.
They are frequently associated with hereditary hemorrhagic telangiectasia (HHT), affecting up to 30% of HHT patients.

Purpose of the Study:

To describe precise techniques for embolizing PAVMs using pushable fibered coils and coaxial/triaxial catheters.
To evaluate the efficacy and recurrence rate of this embolization technique for PAVMs.

Main Methods:

Development of precise coil embolization techniques using coaxial or triaxial catheters for PAVM closure.
Application of the "anchor" or "scaffold" technique for cross-sectional occlusion of PAVMs.
Assessment of treated malformations for permanent involution and recurrence rates.

Main Results:

The described techniques allow for precise placement of fibered coils to achieve cross-sectional occlusion of PAVMs.
Successful treatment resulted in permanent involution of treated malformations.
A low recurrence rate of 3% was observed in treated patients.

Conclusions:

Precise coil embolization using specialized catheter techniques is an effective method for treating PAVMs.
Patients with PAVMs should be screened for HHT and managed at specialized centers.
This approach offers a viable alternative to previously available methods for PAVM closure.