A pulmonary arteriovenous malformation (PAVM) is an abnormal connection between an artery and vein in the lung. Rare and potentially serious, PAVMs are basically a wide-open gap between blood vessels which are normally fenced off from each other by a filter or trap. Without the usual separation, bacteria and blood clots can freely cross normal biological borders and travel throughout the body.

As a result, pulmonary AVMs can cause such dangerous conditions as:

  • Cerebral hemorrhage (bleeding in the brain)
  • Pulmonary hemorrhage (bleeding in the lung)
  • Transischemic attacks or TIAs (mini-strokes)
  • Strokes
  • Brain or spinal infections, including meningitis

Causes and Symptoms

Up to 90 percent of PAVMs arise from a rare genetic condition called Hereditary Hemorrhagic Telangiectasia (HHT) which affects only one out of every 5,000 to 10,000 people. A disorder of the blood vessels, HHT often causes telangiectasias (small spider veins) on the skin of the face and hands and the lining of the nose and mouth. Telangiectasias within the nose can result in recurrent nosebleeds, a very common symptom for those affected by HHT.

Other symptoms of PAVMs include coughing up blood and shortness of breath which can lead to feeling light-headed or dizzy. PAVMs can affect people of any age, including children; however, most patients don’t know they have the condition until they’re between 40 and 60 years old.

While HHT is the predominant cause of pulmonary arteriovenous malformations, the abnormal structures can also form in the aftermath of certain cancers, cardiac surgery or, most often, trauma. But such instances are rare, accounting for only 10 percent of all cases of PAVMs.   

Treatment

Accurate diagnosis of PAVMs followed by prompt intervention is essential to close the abnormal connection and prevent potentially serious complications.  

The first-line treatment for PAVMs today is transcatheter embolization, in which coils or plugs are inserted into the malformation to block the abnormal connection. In this minimally invasive procedure, an interventional radiologist threads a catheter through the groin’s femoral vein, up to the lungs and the site of the PAVM, where the protective device is deposited.

The outpatient procedure typically takes about two hours, with patients returning home the same day.

Make an Appointment

The Interventional Radiology division at MedStar Georgetown University Hospital is equipped and experienced in managing pulmonary arteriovenous malformations and Hereditary Hemorrhagic Telangiectasia (HHT). If you or a loved one is living with or suspected of having either condition, call (202) 444-5478 to schedule a consultation.