Embolization for Pulmonary Arteriovenous Malformations: How to Prevent Recurrence

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal communications between the pulmonary arteries and veins without any intervening capillary beds, and cause hypoxemia, cyanosis, dyspnea, and neurologic complications consisting of transient ischemic attack, stroke, and brain abscess. Thus, treatment for PAVMs is justified even for asymptomatic ones, and recently transcatheter embolization is a common procedure. However, recurrence can occur after the embolization, and attributed to recanalization, pulmonary-to-pulmonary reperfusion, incomplete primary treatment and systemic-to-pulmonary reperfusion. The recurrence may induce neurologic complications, and so it is necessary to perform transcatheter embolization without recurrence. Recanalization is the most frequent recurrence and tight packing is important to prevent it.