Video AVM.avi

Comment

Comment by Gaspar-Alberto Motta-Ramirez on December 22, 2009 at 10:24am

Pulmonary AVFs are abnormal communications between a pulmonary artery and pulmonary vein. Pulmonary AVFs are rare lung anomalies. They are usually congenital. In most cases (70%), pulmonary AVFs affect patients with Rendu-Osler-Weber syndrome (hereditary hemorrhagic telangiectasia) (See videos AVM thorax 3.o B31f and Thorax IV 3.0), which is a systemic autosomal-dominant disorder manifested by mucocutaneous telangiectasias and AVMs, and are a potential source of morbidity and mortality. Lesions can affect the nasopharynx, CNS, lung, liver, and spleen as well as the urinary and gastrointestinal tracts. The incidence of these malformations in the lungs of patients with Rendu-Osler-Weber syndrome ranges from 15% to 33%. The clinical signs of pulmonary AVF depend on the number of fistulas and the sizes of the fistulas. Many patients have no symptoms; others have difficulty breathing and blood in their sputum. When pulmonary involvement is extensive, dyspnea is the most common clinical symptom owing to a right-to-left shunt that produces hypoxemia, a condition that is usually well tolerated. Pulmonary AVF with right-to-left pulmonary shunting is the major cause of transient ischemic attack, brain abscess, and ischemic stroke in patients with Rendu-Osler-Weber syndrome due to paradoxical embolization of bland or septic material into the cerebrovasculature.

The first-line treatment of pulmonary AVF consists of interventional radiology procedures: embolization with coils, silicone balloons, or the Amplatzer vascular plug, a cylindric self-expanding device. The Amplatzer vascular plug has several advantages: It has a reduced risk of migration compared with the other options, releases easily, and can completely occlude an AVF with a single plug.

Review of Imaging Arteriovenous Fistulas, AJR 2009; 193:1425-1433.

Comment by osama ahmed abdalmageed on December 21, 2009 at 3:45am

is it patent ductus arteriosus?