The A-aDO2 rather than the Fick principle can be used to estimate the right-to-left shunt fraction in pulmonary arteriovenous malformation

2020 ◽  
Author(s):  
Jun Nagata ◽  
Toshihiko Sugiura ◽  
Shun Imai ◽  
Ayumi Sekine ◽  
Takayuki Jujo ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformation ◽  
Shunt Fraction ◽  
Fick Principle ◽  
The Right

scholarly journals Pulmonary Arteriovenous Malformation presenting as hemothorax in pregnancy: A case report

2020 ◽  
Vol 23 (1) ◽  
pp. 47-49
Author(s):  
Dinesh Chataut ◽  
Sundar Suwal ◽  
Kamal Subedi ◽  
Ajit Thapa ◽  
Ram Kumar Ghimire ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Coil Embolization ◽  
Lower Lobe ◽  
Acute Onset ◽  
Pulmonary Arteriovenous Malformation ◽  
Image Guided ◽  
Inferior Pulmonary Vein ◽  
Promising Treatment ◽  
The Right

Introduction: Pulmonary arteriovenous malformation (PAVM) is a rare anomaly, mostly congenital, that tends to increase in size with the influence of various factors. Case report: A primigravida at 37 weeks of gestation presented with acute onset of dyspnea due to right sided hemothorax. Computed tomography showed abnormal vessels with pseudoaneurysm in the right lower lobe and shunting between subsegmental branch of right descending pulmonary artery and right inferior pulmonary vein. Embolization of the lesion was planned after immediate cesarean section. Coil embolization with complete occlusion of supplying artery of the lesion was done. Conclusion: PAVM, although rare can result in fatal complications if untreated. Less invasive image guided coil embolization is a promising treatment modality.

scholarly journals Idiopathic Pulmonary Arteriovenous Malformation - A Rare Entity

2021 ◽  
Vol 10 (41) ◽  
pp. 3604-3606
Author(s):  
Sanyukta Hepat ◽  
Ruchita Kabra ◽  
Abhijit Wadekar ◽  
Sourya Acharya ◽  
Samarth Shukla ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Pulmonary Veins ◽  
Pulmonary Arteries ◽  
Surgical Excision ◽  
Transcatheter Embolization ◽  
Pulmonary Angiography ◽  
Pulmonary Arteriovenous Malformation ◽  
Diagnostic Tools ◽  
Delay Of Treatment ◽  
The Right

Pulmonary arteriovenous malformation (PAVM) is one of the rare pulmonary vascular anomalies. Pulmonary arteriovenous malformation results in right to left shunt due to the abnormal communications between the pulmonary arteries and the pulmonary veins bypassing the normal capillary bed.1 This condition being rare could be easily missed, hence, it is essential for clinicians to suspect it based on the classical clinical features. This helps in early diagnosis and deciding further appropriate treatment option. Here we report the case of a patient affected by a large idiopathic pulmonary arteriovenous malformation in the right lung. Most patients with pulmonary arteriovenous malformation are asymptomatic. This is due to the chronic compensation and secondary erythrocytic response. Dyspnoea due to PAVMs are a result of right-to-left shunt. Initial diagnostic tools include chest radiography and contrast enhanced computed tomography but the gold standard is pulmonary angiography.2 Because AVM has substantial morbidity rates associated with it, all patients with PAVMs who can undergo embolization should be treated with transcatheter embolization. In rest of the patients, surgical excision should be considered. The main objective of this study was to highlight the early suspicion and diagnosis of pulmonary arteriovenous malformation as this is easily missed and leads to undue delay of treatment.

scholarly journals Concurrent pulmonary arteriovenous malformation and pulmonary embolism causing stroke: a therapeutic dilemma

2022 ◽  
Vol 5 (1) ◽  
Author(s):  
Jung Guen Cha ◽  
Jihoon Hong
Keyword(s):  
Pulmonary Embolism ◽  
Arteriovenous Malformation ◽  
Treatment Plan ◽  
Rare Condition ◽  
Paradoxical Embolism ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Acute Infarction ◽  
Shunt Occlusion ◽  
The Right

Abstract Background As pulmonary arteriovenous malformation (PAVM) include a right-to-left shunt, it can be accompanied by fatal complications such as stroke and brain abscess due to paradoxical embolism. A concurrent PAVM and pulmonary embolism (PE) is a rare condition. Therefore, the sequence of management has not been established. Case presentation A 62-year-old female patient was transferred to our hospital with a sporadic simple PAVM and concurrent bilateral PE. On chest computed tomography (CT), the acute PE was extended to the segmental pulmonary artery where the feeding artery of PAVM originated. Despite the anticoagulation, the patient complained of left sided weakness on the fifth day of admission, and magnetic resonance imaging revealed an acute infarction in the right lateral thalamus, which was thought to be caused by paradoxical embolism. This situation could lead to a dilemma between the risk of thrombus migration during PAVM embolization and another embolic event due to delayed shunt occlusion during anticoagulation. After a multidisciplinary discussion, a delayed endovascular embolization was performed for PAVM after confirming the complete resolution of PE with 4 months of anticoagulation. The cause of PE in this patient was eventually diagnosed as antiphospholipid syndrome. Conclusion The authors reported a rare case of concurrent PAVM and PE that led to an embolic stroke during hospitalization. This patient was managed with delayed endovascular embolization for PAVM after an anticoagulation for PE and stroke. It is thought to be valuable in deciding for a treatment plan for this rare condition.

Pulmonary Arteriovenous Malformation Treatment with Detachable Balloon: A Case Report

1996 ◽  
Vol 34 (5) ◽  
pp. 595 ◽  
Author(s):  
Young Min Han ◽  
Ho Young Song ◽  
Jeong Min Lee ◽  
Jin Young Chung ◽  
Sang Young Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformation ◽  
Detachable Balloon

scholarly journals Pulmonary arteriovenous malformation (PAVM) embolization: prediction of angiographically-confirmed recanalization according to PAVM Diameter changes on CT

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jihoon Hong ◽  
Sang Yub Lee ◽  
Jung Guen Cha ◽  
Jae-Kwang Lim ◽  
Jongmin Park ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Pulmonary Angiography ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Conventional Angiography ◽  
Receiver Operating Characteristic Curves ◽  
Vein Diameter ◽  
Diameter Reduction

Abstract Background To assess pulmonary arteriovenous malformation (PAVM) recanalization after embolization based on PAVM diameter changes on computed tomography (CT), with pulmonary angiography used as a gold standard. Methods A retrospective review was done of patients from 2008 to 2019 with a PAVM treated with endovascular embolization. The treatment outcome was determined by conventional angiography. Follow-up pulmonary angiography was performed when recanalization was suspected on CT, or embolization of all lesions in multiple PAVM patients could not be completed in a single session. Patients who had no preprocedural or follow-up CT were excluded. Draining vein, feeding artery, and venous sac diameter were measured on CT, and diameter reduction rates were compared with the widely-used, binary 70 % criteria. Results Forty-one patients with 114 PAVMs were treated during the study period. Eight patients with 50 PAVMs met the inclusion criteria. Mean vein, artery, and venous sac diameter reduction rates were as follows: 59.2 ± 9.3 %, 47.5 ± 10.6 %, and 62.6 ± 13.2 %, respectively, in the occluded group and 5.4 ± 19.5 %, 11.3 ± 17.7 %, and 26.8 ± 14.2 %, respectively, in the recanalized group. The area under the receiver operating characteristic curves for PAVM recanalization for the draining vein was 1.00, showing a better result than the artery (0.97) and sac (0.99). Patients showed > 42 % draining vein diameter reduction in the occluded group and < 32 % in the recanalized group. The widely-used 70 % criteria showed low specificity for predicting recanalization (draining vein, 7.3 %; venous sac, 41.7 %) but 100 % sensitivity for both the draining vein and venous sac. Conclusions The widely-used 70 % binary criteria showed limited performance in predicting outcomes in this angiographically-confirmed case series. Further investigations are warranted to establish a strategy for detecting recanalization after PAVM embolization.

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