Pulmonary Arteriovenous Malformations: What the Interventional Radiologist Should Know

Area of Science:

• Vascular Medicine
• Pulmonology
• Genetics

Background:

• Pulmonary arteriovenous malformations (PAVMs) are abnormal direct connections between pulmonary arteries and veins.
• These shunts bypass the lung's capillary bed, leading to a right-to-left shunt.
• A significant majority (80-90%) of PAVMs are associated with hereditary hemorrhagic telangiectasia (HHT).

Purpose of the Study:

• To provide a comprehensive review of pulmonary arteriovenous malformations (PAVMs).
• To cover clinical presentation, diagnostic workup, and genetic associations.
• To detail the standard treatment of transcatheter embolization, including complications and follow-up.

Main Methods:

• Review of clinical presentation and symptoms.
• Discussion of diagnostic imaging findings.
• Analysis of transcatheter embolization as the standard of care.

Main Results:

• PAVMs can be asymptomatic or present with diverse symptoms including hypoxia, dyspnea, and migraines.
• Paradoxical embolization and rupture are potential severe sequelae.
• Transcatheter embolization is the established and effective treatment modality.

Conclusions:

• PAVMs, particularly those associated with HHT, require thorough evaluation and management.
• Transcatheter embolization is the current gold standard for treating PAVMs.
• Understanding PAVM presentation, genetics, and treatment is crucial for patient outcomes.