Dr. Theresa Caridi, Section Chief of Interventional Radiology at UAB School of Medicine, discusses the pathophysiology and treatment of Pulmonary AVM's, as well as the importance of multidisciplinary management of patients with Hereditary Hemorrhagic Telangiectasia (HHT).

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SHOW NOTES

In this episode, Dr. Theresa Caridi joins Dr. Christopher Beck to discuss management and treatment of pulmonary arterial venous malformations (AVMs). We explain what pulmonary AVMs are, why they can be dangerous, and how patients are referred to Hereditary Hemorrhagic Telangiectasia (HHT) Centers of Excellence. We discuss the clinical manifestations of HHT and why it is important to screen for HHT when diagnosing a patient with a pulmonary AVM.

Dr. Caridi tells us about the imaging and how to plan treatments for different types of pulmonary AVM patients. We review the pre-procedural steps and the intricacies of using anesthesia for PAVM treatment. We discuss catheters, access sites, and how to get the images needed. Dr. Caridi shares her advice on working closely to the feeding artery and some of the challenges when using coils.

We discuss what care looks like post-procedure and when to follow up patients. We talk about some of the common side effects that occur after pulmonary AVM treatment. We explain how to decide the number of lesions to treat at one time, and Dr. Caridi gives some advice for those who do not work at an HHT Center of Excellence, but want to perform this procedure.

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RESOURCES

Image Guided Interventions: Expert Radiology Series (IR Textbook by Matthew A. Mauro)

https://www.elsevier.com/books/image-guided-interventions/mauro/978-0-323-61204-3

https://www.amazon.com/Image-Guided-Interventions-Matthew-Mauro-FACR/dp/0323612040/ref=sr_1_1?dchild=1&keywords=Image-Guided+Interventions%3A+Expert+Radiology+Series&qid=1612320492&s=books&sr=1-1

PAVM Embolization: An Update

https://www.ajronline.org/doi/10.2214/AJR.10.5230

Treated pulmonary arteriovenous malformations: patterns of persistence and associated retreatment success

https://pubmed.ncbi.nlm.nih.gov/23912618/

Medtronic Peripheral Embolization Products

https://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/peripheral-embolization.html