ACVRL1 and ischemic stroke: Pulmonary AVMs occur much more frequently in patients with Endoglin mutations (62 %) compared to patients with ACVRL1 mutations (10 %) and complications may be life threatening [19]; Major pulmonary AVM related complications include life-threatening hemorrhage, as well as cerebral abscess (8 %) and ischemic stroke (9 to 18 %) due to paradoxical emboli, which can be fatal or leave patients severely physically impaired [20, 21].