Chest
Unusual Complications After Embolization of a Pulmonary Arteriovenous Malformation
Section snippets
CASE REPORT
A 47-year-old asymptomatic black woman, a nonsmoker with a family history of HHT, was hospitalized for embolization of a right-sided PAVM, which had been found incidentally on a chest radiograph (Fig 1). This patient was part of the population of a previous report on embolization of arteriovenous malformations (AVMs).1 On physical examination multiple telangiectases on skin and mucosal surfaces were seen. A bruit was heard over the right lower lung as well as over the liver. Lung function tests
DISCUSSION
The patient described in this report has HHT with a large PAVM as well as an AVM in the liver. Large systemic AVMs in HHT are rare. They are mostly found in the liver.3 PAVMs are found in 10 to 36% of HHT patients. Nowadays, embolization of the feeding vessels is the therapy of choice for PAVMs. The most common complication is pleurisy, which develops in 10 to 24% of patients.2,4 Occasionally, coronary spasm occurs during embolotherapy.5 Early paradoxic embolization of the material used occurs
REFERENCES (8)
- et al.
Hepatic involvement in hereditary hemorrhagic telangiectasia: clinical, radiological, and hemodynamic studies of 11 cases
Gastroenterology
(1993) - et al.
Pulmonary arteriovenous malformations: therapeutic options
Ann Thorac Surg
(1993) - et al.
Embolisation of pulmonary arteriovenous malformations: results and follow-up in 32 patients
Thorax
(1995) - et al.
Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy
Radiology
(1988)
Cited by (36)
Pulmonary Vascular Abnormalities
2015, Murray and Nadel's Textbook of Respiratory Medicine: Volume 1,2, Sixth EditionPulmonary Arterial Hypertension in a Patient With Hereditary Hemorrhagic Telangiectasia
2013, Archivos de BronconeumologiaHigh output cardiac failure by systemic arteriovenous fistulas in a patient with Osler-Weber-Rendu syndrome
2013, Revista Colombiana de CardiologiaHereditary haemorrhagic telangiectasia: Pathophysiology, diagnosis and treatment
2010, Blood ReviewsCitation Excerpt :The spectrum of disease within the HHT umbrella has extended beyond the telangiectatic/AVM HHT pathology delineated by the Curaçao criteria.2 More recently recognised features include pulmonary arterial hypertension 10; juvenile polyposis 11; pulmonary hypertension in the context of high output cardiac failure secondary to hepatic AVMs, when PH may be reversible after hepatic AVM treatment 12–16; a prothrombotic state associated with elevated plasma levels of factor VIII, 17 and potential immune dysfunction.18 Three of the genes mutated in HHT have been identified: endoglin (resulting in HHT1, OMIM #187300) 19; ACRVL1/ALK1; (resulting in HHT2, OMIM#600376),20 and more rarely, SMAD4 (mutated in HHT in association with juvenile polyposis, JPHT OMIM #175050).11
Percutaneous retrieval of a migrated coil in the left atrium
2010, Radiology Case ReportsCitation Excerpt :Nevertheless, the migration and the entrapment of a coil into the mitral apparatus has never been described. Methods for retrieving a migrated coil from within the cardiac cavities after PAVM embolotherapy have only rarely been reported (13, 14). Both of these cases referred to migration into the ventricles (the left ventricle in the first case and the right ventricle in the second case).
Pulmonary vascular manifestations in hereditary hemorrhagic telangiectasia
2005, Presse Medicale