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DOI: 10.1055/s-2007-985750
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Embolization of Pulmonary Arteriovenous Malformations
Publikationsverlauf
Publikationsdatum:
03. September 2007 (online)
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Pulmonary arteriovenous malformations (PAVM) may be sporadic or occur in association with hereditary hemorrhagic telangiectasia (HHT), also know as Osler-Webber-Rendu syndrome. Several centers nationwide have extensive experience dealing with the latter cohort of patients. These centers have multidisciplinary teams devoted to both diagnosis and treatment of this disease. However, it is not uncommon for patients to present to other hospitals with sporadic PAVMs or to present with initial signs and symptoms of HHT, such as exercise intolerance, stroke, or pulmonary hemorrhage.
Embolization has become the preferred method of treatment for symptomatic PAVMs and asymptomatic lesions > 3 mm in diameter. Incidentally, the 3-mm threshold is a relatively arbitrary criterion based on empirical observation. It was chosen when embolization of smaller lesions was technically impractical with the equipment available at the time. Currently, with the armamentarium of available microcatheters and embolic agents, some interventional radiologists will treat any and all lesions identified on pulmonary angiography. A comprehensive overview of treatment is beyond the scope of this brief article. Instead, I review three embolization techniques useful in the treatment of these lesions and applicable to a wider range of lesions with similar anatomy.
SUGGESTED READINGS
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Brian FunakiM.D.
Section of Vascular and Interventional Radiology, University of Chicago Hospitals
5840 S. Maryland Avenue, MC 2026, Chicago, IL 60637