Pulmonary arteriovenous malformations: a clinical review

Abstract

Pulmonary arteriovenous malformations (PAVMs) are a rare clinical entity. Most of them are associated with hereditary haemorrhagic telangiectasia. The usual clinical presentation is exertional dyspnoea and hypoxaemia. The initial test of choice for screening is the 100% oxygen method. A pulmonary angiogram is needed to define the anatomy and guide transcatheter embolisation (TCE). TCE has been shown to be eVective and safe with a very low recanalisation rate and has largely replaced surgery for PAVMs. Computed tomography of the chest can be used for the follow up of asymptomatic PAVMs and TCE. (Postgrad Med J 2000;76:390-394)

Multiple Pulmonary Arteriovenous Fistula in a Mother and His Son: A Case Report

“…Several diagnostic modalities can be used to detect PAVFsincluding the 100% oxygen method, radionuclide imaging, and contrast echocardiography [4]. However, angiography remains the gold standard for diagnosis.…”

“…Catheterization is performed via the femoral vein; the feeding artery of PAVFs is catheterized and steel coils or detachable balloons are advanced through the catheter [4]. It is recommended that pulmonary angiography be repeated to ensure the proper occlusion of PAVFs [16].…”

“…However, these abnormal communications between pulmonary arteries and veins are commonly seen in patients with hereditary hemorrhagic telangiectasia (HHT) (also known as the Osler-Weber-Rendu syndrome) [2,3]. Aside from the congenital etiology, several conditions may lead to acquired forms of multiple PAVFs-including cirrhosis, chest trauma, metastatic carcinoma, schistosomiasis, and systemic amyloidosis [4,5]. The most common clinical symptom of multiple PAVFs is dyspnea on exertion, reported in 13% to 55% of patients in different reports [5][6][7].…”

Detachable coiling for embolotherapy of high-flow pulmonary arteriovenous malformation: case report and review of the literature

“…Surgical resection is thus indicated in cases of intrapleural rupture or lesions not amenable to embolotherapy (8), although up-to-date embolization technique and material lead to successful occlusion in the near-totality of the patients.…”

“…Contrast echocardiography (with intravenous injection of agitated saline to create microbubbles) is useful to establish the diagnosis of right-to-left shunt, but is inaccurate in quantifying the shunt fraction, which is done by radionuclide imaging, or far less costly, by the 100% Oxygen method (8).…”