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Purpose

Up to 25% of initially occluded PAVMs demonstrate persistent flow during follow-up surveillance imaging after endovascular embolization. Some providers have proposed that the presence of embolic material in persistent PAVMs effectively filter clinically significant paradoxical emboli, while others theorize that persistent PAVMs pose a higher risk due to a slow-flow state allowing in-situ thrombus formation. No specific recommendations exist for when asymptomatic recurrent lesions should be treated. In such cases, the goal of treatment would be to mitigate the risk of paradoxical embolism. We report incidence of embolic phenomena among 13 consecutive patients with isolated recurrent PAVMs following treatment with endovascular embolization.

Materials and Methods

A retrospective review of electronic medical and imaging records was conducted in patients with recurrent PAVMs at a single HHT Center …