Chest
Volume 109, Issue 5, May 1996, Pages 1401-1404
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Unusual Complications After Embolization of a Pulmonary Arteriovenous Malformation

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A pulmonary arteriovenous malformation was embolized in a patient with hereditary hemorrhagic telangiectasia. Several unusual complications, including early deflation of a detachable balloon, migration of a coil, and development of severe pulmonary hypertension, occurred. Pulmonary hypertension was attributed to a coexistent left-to-right shunt caused by a large hepatic 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)

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