Diagnosis and Management of Persistent Pulmonary Arterio-venous Malformations following Embolotherapy

Abstract

Embolotherapy is the primary treatment for pulmonary arterio-venous malformations (PAVMs). Approximately, 2-25% of PAVMs demonstrate persistence following embolization. Early identification and treatment of persistent PAVMs are critical to mitigating life threatening complications. The presence of prior embolic devices and complex angioarchitecture of persistent PAVMs pose technical challenges during repeat embolotherapy. In this article, we review patterns of persistence, factors affecting the persistence, endovascular treatment techniques, and outcomes.

Keywords: Embolization; Hereditary Haemorrhagic telangiectasia (HHT); Multidetector Computed Tomography; Pulmonary angiogram; Pulmonary arteriovenous malformation (PAVM); Time-resolved Magnetic Resonance Angiography (TR-MRA).