Anesthetic Considerations for Pulmonary Arteriovenous Malformation Embolization in a Patient With Hereditary Hemorrhagic Telangiectasia: A Case Report

Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectases and visceral arteriovenous malformations (AVMs). Pulmonary AVMs (PAVMs) create an anatomic right-to-left shunt, increasing the risk of hypoxemia and paradoxical embolic events, and are commonly treated with transcatheter embolization. We report a 25-year-old man with suspected HHT based on Curaçao criteria, including recurrent epistaxis, prior cerebral AVM, and multiple PAVMs, presenting with exertional dyspnea and hypoxemia. He underwent embolization under general anesthesia with air management, lung isolation capability, and tailored ventilatory management. The procedure was completed without complications, with resolution of symptoms and normalization of oxygenation. This case highlights the importance of understanding PAVM pathophysiology and implementing targeted anesthetic strategies to ensure safe perioperative management.