Pulmonary Arteriovenous Malformation Treatment

  • F. Gonca Eldem
  • Bora Peynircioglu
  • Barbaros E. Cil


Pulmonary arteriovenous malformations (PAVMs) are abnormal direct communications between a pulmonary artery and pulmonary vein. PAVMs can be simple (consist of a single feeding vessel and a nonseptated aneurysmal sac with a single draining vein) or complex type (consist of multiple feeding arteries, multiple draining veins, and septated arteriovenous connections). Complex PAVMs constitute approximately 10 % of these lesions.


Hereditary Hemorrhagic Telangiectasia Contrast Echocardiography Amplatzer Vascular Plug Platinum Coil Pulmonary Arteriovenous Malformation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Burke CM, Safai C, Nelson DP, Raffin TA. Pulmonary arteriovenous malformations: a critical update. Am Rev Respir Dis. 1986;134(2):334–9.PubMedGoogle Scholar
  2. 2.
    Guttmacher AE, Marchuk DA, White Jr RI. Hereditary hemorrhagic telangiectasia. N Engl J Med. 1995;333(14):918–24.PubMedCrossRefGoogle Scholar
  3. 3.
    White RI. Pulmonary arteriovenous malformations: how do I embolize? Tech Vasc Interv Radiol. 2007;10(4):283–90.PubMedCrossRefGoogle Scholar
  4. 4.
    Trerotola SO, Pyeritz RE. PAVM embolization: an update. AJR Am J Roentgenol. 2010;195(4):837–45.PubMedCrossRefGoogle Scholar
  5. 5.
    Begbie ME, Wallace GM, Shovlin CL. Hereditary haemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): a view from the 21st century. Postgrad Med J. 2003;79(927):18–24. PMCID: 1742589.PubMedCrossRefGoogle Scholar
  6. 6.
    Shovlin CL, Guttmacher AE, Buscarini E, et al. Diagnostic criteria for hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome). Am J Med Genet. 2000;91(1):66–7.PubMedCrossRefGoogle Scholar
  7. 7.
    White Jr RI, Pollak JS, Wirth JA. Pulmonary arteriovenous malformations: diagnosis and transcatheter embolotherapy. J Vasc Interv Radiol. 1996;7(6):787–804.PubMedCrossRefGoogle Scholar
  8. 8.
    Kaufman JA. Pulmonary circulation. In: Kaufman JA, Lee MJ, editors. Vascular and interventional radiology-the requesites. Philadelphia: Mosby/Elsevier; 2004. p. 194–218.Google Scholar
  9. 9.
    Gossage JR, Kanj G. Pulmonary arteriovenous malformations. A state of the art review. Am J Respir Crit Care Med. 1998;158(2):643–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Elmali ME, Akan H, Findik S, Kale M, Celenk C. Hereditary hemorrhagic telangiectasia associated with pulmonary arteriovenous malformations presenting as hemothorax. J Thorac Imaging. 2008;23(4):295–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Gallitelli M, Pasculli G, Fiore T, Carella A, Sabba C. Emergencies in hereditary haemorrhagic telangiectasia. QJM. 2006;99(1):15–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Schneider G, Uder M, Koehler M, et al. MR angiography for detection of pulmonary arteriovenous malformations in patients with hereditary hemorrhagic telangiectasia. AJR Am J Roentgenol. 2008;190(4):892–901.PubMedCrossRefGoogle Scholar
  13. 13.
    Carette MF, Nedelcu C, Tassart M, Grange JD, Wislez M, Khalil A. Imaging of hereditary hemorrhagic telangiectasia. Cardiovasc Intervent Radiol. 2008;32(4):745–57.PubMedCrossRefGoogle Scholar
  14. 14.
    Remy J, Remy-Jardin M, Wattinne L, Deffontaines C. Pulmonary arteriovenous malformations: evaluation with CT of the chest before and after treatment. Radiology. 1992;182(3):809–16.PubMedGoogle Scholar
  15. 15.
    Engelke C, Schaefer-Prokop C, Schirg E, Freihorst J, Grubnic S, Prokop M. High-resolution CT and CT angiography of peripheral pulmonary vascular disorders1. Radiographics. 2002;22(4):739–64.PubMedGoogle Scholar
  16. 16.
    Lee WL, Graham AF, Pugash RA, et al. Contrast echocardiography remains positive after treatment of pulmonary arteriovenous malformations. Chest. 2003;123(2):351–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Gupta P, Mordin C, Curtis J, Hughes JM, Shovlin CL, Jackson JE. Pulmonary arteriovenous malformations: effect of embolization on right-to-left shunt, hypoxemia, and exercise tolerance in 66 patients. AJR Am J Roentgenol. 2002;179(2):347–55.PubMedCrossRefGoogle Scholar
  18. 18.
    Hsu CCT, Kwan GNC, Thompson SA, van Driel ML. Embolisation therapy for pulmonary arteriovenous malformations. Cochrane Database Syst Rev. 2010; (5):CD008017. doi:  10.1002/14651858.CD008017.pub2.
  19. 19.
    Pollak JS, Saluja S, Thabet A, Henderson KJ, Denbow N, White Jr RI. Clinical and anatomic outcomes after embolotherapy of pulmonary arteriovenous malformations. J Vasc Interv Radiol. 2006;17(1):35–44; quiz 5.PubMedCrossRefGoogle Scholar
  20. 20.
    Faughnan ME, Palda VA, Garcia-Tsao G, et al. International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet. 2009;48(2):73–87.PubMedCrossRefGoogle Scholar
  21. 21.
    Trerotola SO, Pyeritz RE, Bernhardt BA. Outpatient single-session pulmonary arteriovenous malformation embolization. J Vasc Interv Radiol. 2009;20(10):1287–91.PubMedCrossRefGoogle Scholar
  22. 22.
    Prasad V, Chan RP, Faughnan ME. Embolotherapy of pulmonary arteriovenous malformations: efficacy of platinum versus stainless steel coils. J Vasc Interv Radiol. 2004;15(2):153–60.PubMedCrossRefGoogle Scholar
  23. 23.
    White Jr RI, Pollak JS. Controlled delivery of pushable fibered coils for large vessel embolotherapy. In: Vascular embolotherapy: a comprehensive approach. Heidelberg/Germany: Springer; 2006.Google Scholar
  24. 24.
    Cil BE, Erdogan C, Akmangit I, Cekirge S, Balkanci F. Use of the TriSpan coil to facilitate the transcatheter occlusion of pulmonary arteriovenous malformation. Cardiovasc Intervent Radiol. 2004;27(6):655–8.PubMedCrossRefGoogle Scholar
  25. 25.
    Ferro C, Rossi UG, Bovio G, Seitun S, Rossi GA. Percutaneous transcatheter embolization of a largAe pulmonary arteriovenous fistula with an Amplatzer vascular plug. Cardiovasc Intervent Radiol. 2007;30(2):328–31.PubMedCrossRefGoogle Scholar
  26. 26.
    Cil B, Canyigit M, Ozkan OS, Pamuk GA, Dogan R. Bilateral multiple pulmonary arteriovenous malformations: endovascular treatment with the Amplatzer Vascular Plug. J Vasc Interv Radiol. 2006;17(1):141–5.PubMedCrossRefGoogle Scholar
  27. 27.
    Hart JL, Aldin Z, Braude P, Shovlin CL, Jackson J. Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients. Eur Radiol. 2010;20(11):2663–70.PubMedCrossRefGoogle Scholar
  28. 28.
    Cil B, Peynircioglu B, Canyigit M, Geyik S, Ciftci T. Peripheral vascular applications of the Amplatzer vascular plug. Diagn Interv Radiol. 2008;14(1):35–9.PubMedGoogle Scholar
  29. 29.
    Hill SL, Hijazi ZM, Hellenbrand WE, Cheatham JP. Evaluation of the AMPLATZER vascular plug for embolization of peripheral vascular malformations associated with congenital heart disease. Catheter Cardiovasc Interv. 2006;67(1):112–8.CrossRefGoogle Scholar
  30. 30.
    Letourneau-Guillon L, Faughnan ME, Soulez G, et al. Embolization of pulmonary arteriovenous malformations with amplatzer vascular plugs: safety and midterm effectiveness. J Vasc Interv Radiol. 2010;21(5):649–56.PubMedCrossRefGoogle Scholar
  31. 31.
    Abdel Aal AK, Hamed MF, Biosca RF, Saddekni S, Raghuram K. Occlusion time for amplatzer vascular plug in the management of pulmonary arteriovenous malformations. AJR Am J Roentgenol. 2009;192(3):793–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Milic A, Chan RP, Cohen JH, Faughnan ME. Reperfusion of pulmonary arteriovenous malformations after embolotherapy. J Vasc Interv Radiol. 2005;16(12):1675–83.PubMedCrossRefGoogle Scholar
  33. 33.
    Fidelman N, Gordon RL, Bloom AI, LaBerge JM, Kerlan RK. Reperfusion of pulmonary arteriovenous malformations after successful embolotherapy with vascular plugs. J Vasc Interv Radiol. 2008;19(8):1246–50.PubMedCrossRefGoogle Scholar
  34. 34.
    Trerotola SO, Pyeritz RE. Does use of coils in addition to amplatzer vascular plugs prevent recanalization? AJR Am J Roentgenol. 2010;195(3):766–71.PubMedCrossRefGoogle Scholar
  35. 35.
    Andersen PE, Kjeldsen AD. Interventional treatment of pulmonary arteriovenous malformations. World J Radiol. 2010;2(9):339–44.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • F. Gonca Eldem
    • 1
  • Bora Peynircioglu
    • 1
  • Barbaros E. Cil
    • 1
  1. 1.Faculty of Medicine, Department of RadiologyHacettepe University HospitalsAnkaraTurkey

Personalised recommendations