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Vascular Embolotherapy pp 279–296Cite as

Pulmonary Arteriovenous Malformations

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

17.11 Conclusion and Perspectives

Although embolization is a safe and effective treatment in the management of PAVMs, long-term follow-up of patients is mandatory to document aneurysmal retraction or reperfusion of treated lesions and to detect growth of small PAVMs reaching the threshold size for neurologic emboli. From a technical point of view, it is important to perform the embolization with coils placed as distally as possible in the feeding vessel to a PAVM close to the venous sac. This technique avoids the occlusion of branches to normal lung and reduces the rate of reperfusion and the risk of pleurisy or pulmonary infarction. In patients with localized PAVMs, prevention of neurological complications can be achieved in almost all cases if all PAVMs are occluded. Conversely in patients with diffuse PAVMs, multiple procedures will be necessary to improve the profound hypoxia, decrease the risks of neurological events and obtain an acceptable quality-of-life.

Embolization of PAVMs requires a specific expertise and should be performed by specially-trained interventional radiologists only. Pluridisciplinary management of PAVMs in HHT is mandatory in order to apply the appropriate treatment and to fully educate the patients and their family about the diagnosis, its clinical implications, and its hereditary nature.

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Authors and Affiliations

  1. Department of Radiology Hôpital Ambroise Pare, 9, Avenue Charles De Gaulle, 92104, Boulogne Cedex, France

    Jean-Pierre Pelage MD, PhD & Pascal Lacombe MD

  2. Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, Room 5039 LMP, New Haven, CT, 06520, USA

    Robert I. White Jr. MD

  3. Department of Diagnostic Radiology, Yale University School of Medicine, PO Box 20842, New Haven, CT, 06504-8042, USA

    Jeffray S. Pollak MD

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  1. Jean-Pierre Pelage MD, PhD
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  2. Pascal Lacombe MD
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  4. Jeffray S. Pollak MD
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Editors and Affiliations

  1. Department of Radiology, University of Iowa Hospitals and Clinics, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Jafar Golzarian MD (Professor of Radiology) (Professor of Radiology)

  2. University of Iowa Hospitals and Clinics, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Shiliang Sun MD (Associate Professor of Radiology) (Associate Professor of Radiology)

  3. Departments of Radiology and Surgery, University of Iowa Hospitals and Clinics, Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA

    Melhelm J. Sharafuddin MD

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Pelage, JP., Lacombe, P., White, R.I., Pollak, J.S. (2006). Pulmonary Arteriovenous Malformations. In: Golzarian, J., Sun, S., Sharafuddin, M.J. (eds) Vascular Embolotherapy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-33256-1_22

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