Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Successful Treatment of a Large Pulmonary Arteriovenous Malformation by Repeated Coil Embolization

  • Park, Jimyung (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Hyung-Jun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) ;
  • Kim, Jee min (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital) ;
  • Park, Young Sik (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2015.06.25
  • Accepted : 2015.08.13
  • Published : 2015.10.30
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Abstract

Pulmonary arteriovenous malformations (AVMs) are caused by abnormal vascular communications between the pulmonary arteries and pulmonary veins, which lead to the blood bypassing the normal pulmonary capillary beds. Pulmonary AVMs result in right-to-left shunts, resulting in hypoxemia, cyanosis, and dyspnea. Clinical signs and symptoms vary depending on the size, number, and flow of the AVMs. Transcatheter embolization is the treatment of choice for pulmonary AVMs. However, this method can fail if the AVM is large or has multiple complex feeding arteries. Surgical resection is necessary in those kind of cases. Here, we report the case of a patient with a 6-cm pulmonary AVM with multiple feeding arteries that was successfully treated by repeated coil embolization without surgery.

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References

  1. Shovlin CL. Pulmonary arteriovenous malformations. Am J Respir Crit Care Med 2014;190:1217-28. https://doi.org/10.1164/rccm.201407-1254CI
  2. Khurshid I, Downie GH. Pulmonary arteriovenous malformation. Postgrad Med J 2002;78:191-7. https://doi.org/10.1136/pmj.78.918.191
  3. Cartin-Ceba R, Swanson KL, Krowka MJ. Pulmonary arteriovenous malformations. Chest 2013;144:1033-44. https://doi.org/10.1378/chest.12-0924
  4. Gossage JR, Kanj G. Pulmonary arteriovenous malformations: a state of the art review. Am J Respir Crit Care Med 1998;158: 643-61. https://doi.org/10.1164/ajrccm.158.2.9711041
  5. Lee DW, White RI Jr, Egglin TK, Pollak JS, Fayad PB, Wirth JA, et al. Embolotherapy of large pulmonary arteriovenous malformations: long-term results. Ann Thorac Surg 1997;64:930-9. https://doi.org/10.1016/S0003-4975(97)00815-1
  6. Kim HJ, Lee JS, Oh YM, Shim TS, Lim CM, Koh YS, et al. Clinical characteristics of pulmonary arteriovenous malformations in Koreans. Respirology 2015;20:155-9.
  7. Iqbal M, Rossoff LJ, Steinberg HN, Marzouk KA, Siegel DN. Pulmonary arteriovenous malformations: a clinical review. Postgrad Med J 2000;76:390-4. https://doi.org/10.1136/pmj.76.897.390
  8. Hsu CC, Kwan GN, Thompson SA, Evans-Barns H, van Driel ML. Embolisation for pulmonary arteriovenous malformation. Cochrane Database Syst Rev 2015;1:CD008017.
  9. Milic A, Chan RP, Cohen JH, Faughnan ME. Reperfusion of pulmonary arteriovenous malformations after embolotherapy. J Vasc Interv Radiol 2005;16:1675-83. https://doi.org/10.1097/01.RVI.0000182163.25493.BB
  10. Hart JL, Aldin Z, Braude P, Shovlin CL, Jackson J. Embolization of pulmonary arteriovenous malformations using the Amplatzer vascular plug: successful treatment of 69 consecutive patients. Eur Radiol 2010;20:2663-70. https://doi.org/10.1007/s00330-010-1851-2
  11. Kucukay F, Ozdemir M, Senol E, Okten S, Ereren M, Karan A. Large pulmonary arteriovenous malformations: long-term results of embolization with AMPLATZER vascular plugs. J Vasc Interv Radiol 2014;25:1327-32. https://doi.org/10.1016/j.jvir.2014.01.031

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