Patient selection: pulmonary arteriovenous shunt (PAVM)
Options:
(1) embolization
(2) limited surgical resection (if embolization contraindicated and disease local)
(3) lung transplant (only if severe complications and no other recourse)
Embolization is recommended even if the patient is asymptomatic.
Relative contraindications for embolization:
(1) pregnancy
(2) pulmonary hypertension
(3) renal impairment
(4) lack of adequate expertise to perform interventional radiology
Complete obliteration by embolization may not be achievable if:
(1) there are multiple PAVM
(2) the patient has hereditary hemorrhagic telangiectasia
A patient undergoing embolization should be followed in order to detect recanalization or change in the PAVM.
