Approach to Pulmonary Arteriovenous Malformations: A Comprehensive Update

Area of Science:

• Vascular Medicine
• Cardiology
• Genetics

Background:

• Pulmonary arteriovenous malformations (PAVMs) are abnormal vascular connections between pulmonary arteries and veins.
• Often congenital and associated with hereditary hemorrhagic telangiectasia (HHT), PAVMs create right-to-left shunts.
• PAVMs can lead to hypoxemia, dyspnea, and severe complications like stroke, even when asymptomatic.

Purpose of the Study:

• To provide an updated review on the diagnosis and management of PAVMs.
• To emphasize areas of controversy in PAVM screening and treatment.
• To present an institutional approach based on current literature.

Main Methods:

• Literature review of current research on PAVMs.
• Analysis of institutional experience in managing PAVMs.
• Focus on diagnostic workup and treatment strategies, including transcatheter embolotherapy.

Main Results:

• PAVMs present a diagnostic and management challenge due to debated aspects.
• Transcatheter embolotherapy is the established gold standard for PAVM treatment.
• Early detection and management are crucial to prevent severe complications such as stroke and brain abscess.

Conclusions:

• An updated, evidence-based approach to PAVM diagnosis and management is needed.
• Addressing controversial areas in PAVM care is essential for optimal patient outcomes.
• Continued research and expert consensus are vital for refining PAVM screening and treatment protocols.