Treatment:

A small number of patients who have no symptoms may need no specific treatment. For most patients with either single or multiple fistulas, the treatment of choice is surgery to remove the abnormal vessels and the adjacent lung tissue.

For some patients, it may be possible to block the fistula at the time of arteriogram.

Expectations (prognosis):

The outlook for patients with HHT is less favorable than for those without HHT. The result of surgery to remove the abnormal vessels is usually good, and recurrence is unlikely.

Recurrence is possible if the treatment is to block the fistula (embolization).

Complications:

The most worrisome complication for patients with untreated pulmonary arteriovenous fistulas is "paradoxical embolism" -- where a blood clot travels from the lungs to the arms, legs, or brain (if it travels to the brain, it can produce a stroke). Major complications after treatment for this condition are unusual.

Calling your health care provider:

Patients with frequent nosebleeds or difficulty breathing, especially if there is also a history of HHT, should consult their physician.