Treatment of Recurrent Pulmonary Arteriovenous Malformations: Comparison of Proximal Versus Distal Embolization Technique

  title={Treatment of Recurrent Pulmonary Arteriovenous Malformations: Comparison of Proximal Versus Distal Embolization Technique},
  author={Lucas R. Cusumano and Gary R. Duckwiler and Dustin G. Roberts and Justin P. McWilliams},
  journal={CardioVascular and Interventional Radiology},
Purpose To examine the characteristics of recurrent pulmonary arteriovenous malformations (PAVMs) and compare the success of proximal versus distal embolization technique for treatment of recanalized PAVMs. Materials Between July 2007 and October 2018, 26 consecutive patients underwent embolization of 64 previously treated recurrent PAVMs at a single center with imaging follow-up. PAVM angioarchitecture was classified as either simple (1 feeding artery) or complex (≥ 2 feeding arteries). The… 

Embolization of Recurrent Pulmonary Arteriovenous Malformations by Ethylene Vinyl Alcohol Copolymer (Onyx®) in Hereditary Hemorrhagic Telangiectasia: Safety and Efficacy

In HHT, treatment of recurrent PAVM with Onyx® showed satisfactory safety and efficacy, with an immediate occlusion rate of 100% and a long-term rate of 60%.

Percutaneous Puncture Embolization for Recurrent Pulmonary Arteriovenous Malformation After Failed Initial Treatment: A Case Report.

This case was unique as a portion of the PAVMs was closely attached to the chest wall and PVP was slightly increased, which made percutaneous puncture embolization possible, which can be helpful in the treatment of recurrent PAVM in patients who cannot undergo re-embolization through pulmonary artery.

Diagnosis and Transvascular Embolization for Ruptured Pulmonary Arteriovenous Malformations: Outcomes from a 12 Years’ Retrospective Study

Computed tomography angiography (CTA) was able to diagnose ruptured PAVMs, and embolotherapy led to successful resolution of symptoms in all 18 patients who had rupturedPAVMs.

Approach to Pulmonary Arteriovenous Malformations: A Comprehensive Update

The authors of this review present an updated approach to the diagnostic workup and management of PAVMs, with an emphasis on areas of controversy, based on the latest literature and institutional experience.

Massive haemorrhagic complications of ruptured pulmonary arteriovenous malformations: outcomes from a 12 years’ retrospective study

Embolotherapy is an effective therapy for this life-threatening complication of ruptured PAVMs and HHT and larger size of afferent arteries are major risk factors of these complications.

Two cases of massive hemoptysis due to bronchial artery supply to previously embolized pulmonary arteriovenous malformation

Two patients who experienced massive hemoptysis during follow up after pulmonary artery embolization with coils for Pulmonary Arteriovenous Malformations (PAVM) may indicate that bronchial artery supply is the cause of both hemopTYsis and reperfusion of treated PAVMs.

Predictors of heart failure symptoms in hereditary hemorrhagic telangiectasia patients with hepatic arteriovenous malformations

CTA is an effective and easily reproducible method to evaluate hepatic involvement of HHT and both CHA diameter and hemoglobin level were independent predictors of heart failure symptoms.

Unusual Course of Pulmonary and Brain Arteriovenous Malformation: A Case Report

A rare case of pulmonary and brain malformation has been reported, which has progressed even after treatment and has been closed interventionally, and patients with pulmonary AVMs need careful examination for other congenital disorders.

Hereditary haemorrhagic telangiectasia and pulmonary arteriovenous malformations

A 33-year-old woman presenting with progressive dyspnoea during the COVID-19 pandemic had a typical presentation of HHT with recurrent epistaxis, telangiectasia and pulmonary arteriovenous malformations, and PAVM should be considered in individuals presenting to the emergency department with dysPNoea and hypoxaemia.



Embolotherapy of pulmonary arteriovenous malformations: long-term results in 112 patients.

Embolotherapy of PAVMs is efficacious and durable in the majority of patients and should remain under regular review because recanalization ofPAVMs or enlargement of untreated PAV Ms can occur years after treatment.

Pulmonary arteriovenous malformations treated with embolotherapy: helical CT evaluation of long-term effectiveness after 2-21-year follow-up.

Evaluating the long-term results of transcatheter embolotherapy of pulmonary arteriovenous malformations (PAVMs) with helical computed tomography (CT) revealed successful embol Therapy of 75% and partially or completely failed embol therapy of 25% of PAVMs.

Reperfusion of pulmonary arteriovenous malformations after embolotherapy.

Recanalization is the most common mechanism of PAVM reperfusion and increased feeding artery diameter, low number of coils, use of oversized coils, and proximal coil placement within the feeding artery are associated with reperfusions.

Treated pulmonary arteriovenous malformations: patterns of persistence and associated retreatment success.

Recanalization through previously placed coils is the most common pattern of PAVM persistence and responds best to retreatment, while Pulmonary-to-pulmonary reperfusion is less common and more difficult to re-treat successfully.

Clinical and anatomic outcomes after embolotherapy of pulmonary arteriovenous malformations.

Clinical and anatomic evaluation after pulmonary AVM embolization is important to detect persistent or reperfused lesions and enlarging lesions, with the latter more common.

Transcardiac Retrograde Transvenous Embolization of Proximally Occluded Pulmonary Arteriovenous Malformation

A novel transcardiac retrograde transvenous embolization is useful for inadequately treated pulmonary AVM with proximal feeding artery occlusion and dyspnea on exertion disappeared.

Pulmonary arteriovenous malformations: how do I embolize?

  • Robert I. White
  • Medicine
    Techniques in vascular and interventional radiology
  • 2007
Pulmonary arteriovenous malformations (PAVM) are high-flow, low-pressure shunts, consisting of a single feeding artery connecting via an aneurysmal sac to a draining vein, which are markers of hereditary hemorrhagic telangiectasia (HHT).