Percutaneous closure of a giant pulmonary arteriovenous malformation using multiple devices

Abstract

Percutaneous device closure is an established method to treat pulmonary arteriovenous malformation (PAVM). This report describes the case of a 23-year-old man with hereditary hemorrhagic telangiectasia (HHT) presenting with dyspnea and hypoxia. The patient was found to have a giant left-sided PAVM. The patient underwent percutaneous closure of PAVM with multiple devices with a good outcome. At 12month follow up, the patient was asymptomatic with near complete obliteration of the arteriovenous malformation. <Learning objective: This case demonstrates the feasibility and safety of using multiple devices to treat pulmonary arteriovenous malformation percutaneously. Good short-term (12-month) outcomes are demonstrated and there were no complications.>

Unusual Course of Pulmonary and Brain Arteriovenous Malformation: A Case Report

“…However, due to the presence of a resistant blood-brain barrier and abundant cerebral circulation, the probability of these abscesses following pulmonary AVM is about 5% (11), which was also observed in our patient, that can be due to the spread, reanalyzed and new lesion with a high volume of the shunt inside the lungs (12).…”

“…Safety and efficacy of endovascular methods in patients with AVMs has been proven, but due to high preva- lence of complications and the risk of recurrence of longterm follow-up lesions, it is recommended to undergo high resolution CT scans every three to five years for lung lesions (11). Furthermore, the use of anticoagulants have been reported to prevent brain damage, nevertheless whether these drugs are safe or not should be further investigated (15).…”

Percutaneous occlusion of five pulmonary arteriovenous fistulas in the same pulmonary lobe

“…In recent years, Amplatzer ® devices have been the preferred device for occlusion of this type and, in general, for vascular malformations 5,6 . In the review of national and international publications, we did not find another case in which this number of malformations has been occluded percutaneously in the same patient and especially in the same lung, in some of the reported cases they were single lesions, and in those with multiple pulmonary arteriovenous fistulas, the location and/or size was not feasible for closure [7][8][9] .…”

Oclusión percutánea de cinco fístulas arteriovenosas pulmonares en el mismo lóbulo pulmonar

“…In recent years, Amplatzer® devices have been the preferred device for occlusion of this type and, in general, for vascular malformations 5,6 . In the review of national and international publications, we did not find another case in which this number of malformations has been occluded percutaneously in the same patient and especially in the same lung, in some of the reported cases they were single lesions, and in those with multiple pulmonary arteriovenous fistulas, the location and/or size was not feasible for closure [7][8][9] .…”