Pulmonary Arteriovenous Malformation and Its Vascular Mimickers

Abstract

Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

Large pulmonary arteriovenous malformation lost to follow-up with 10 years of asymptomatic interval growth: A case report

“…Biopsies are associated with an increased risk of severe bleeding and stroke and are not recommended in the routine workup of PAVMs [ 15 ]. Differential diagnosis includes other causes of right-to-left shunts, such as congenital heart disease or hepatopulmonary syndrome, and radiologic mimics include other causes of pulmonary aneurysmal disease, pulmonary varices, pulmonary arterial collaterals, and nonvascular abnormalities including bronchocele or tumors [ 11 , 16 ].…”

Case report: video-assisted thoracoscopic surgery for pulmonary arteriovenous malformation using near-infrared fluorescence with indocyanine green

“…According to a systematic review of the Cochrane database, no randomized controlled trials (RCTs) have proven PTE to be the mainstream treatment for PAVMs [ 13 ]. Moreover, some vascular mimickers of PAVMs require surgical resection [ 14 ]. The advent of thoracoscopy has unleashed the potential for radical and least-invasive treatment.…”

Case Report: Video-Assisted Thoracoscopic Surgery for Pulmonary Arteriovenous Malformation Using Near-Infrared Fluorescence with Indocyanine Green

“…According to a systematic review of the Cochrane database, no RCTs have proven PTE to be the mainstream treatment for PAVMs [9]. Moreover, some vascular mimickers of PAVMs require surgical resection [10]. The advent of thoracoscopy has unleashed potential for radical least invasive treatment.…”