Review question

We reviewed the evidence about the effect of blocking the blood vessels which feed abnormal direct connections between arteries and veins in people who have these in their lungs.

Background

Pulmonary arteriovenous malformations are abnormal connections between arteries and veins in the lung which can cause serious complications such as stroke, brain abscess, bleeding in the lung and poor oxygenation. Embolisation is the mainstream treatment for pulmonary arteriovenous malformations. During the procedure, balloon or coil embolisation devices (or both combined) are used to block the feeding artery or arteries to the malformation. These malformations can often be small, multiple and widely spread out, so not all of them are suitable for embolisation treatment.

This is an update of a previously published review.

Search date

The evidence is current to: 10 April 2017.

Study characteristics

In this systematic review, we did not include any randomised controlled trials of embolisation versus surgery or comparing different embolisation devices. We have identified one ongoing trial comparing two different embolisation devices which might be eligible for inclusion in the review when it is completed.

Key results

While no randomised controlled trials of this treatment are included in this review, a number of observational studies have suggested embolisation therapy has benefits. However, randomised controlled trials are not always feasible on ethical grounds. In the absence of randomised controlled trials, a standardised approach to reporting, as well as long-term follow-up through registry studies can help to improve the safety and outcome of embolisation for pulmonary arteriovenous malformations.

Quality of the evidence

We have not been able to present any evidence from randomised controlled trials in this version of the review.