scholarly journals Pulmonary Arteriovenous Malformation in Combination With Stroke.

2021 ◽  
Author(s):  
Jung Guen Cha ◽  
Jihoon Hong
Keyword(s):  
Pulmonary Embolism ◽  
Arteriovenous Malformation ◽  
Treatment Plan ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Feeding Artery ◽  
Complex Situation ◽  
Segmental Artery

Abstract BackgroundAs 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. There are few PAVM patients accompanied by concurrent pulmonary embolism, so the treatment sequence has not been established. Case presentationA 62-year-old female patient was transferred to our hospital with a simple PAVM and concurrent bilateral pulmonary embolism (PE). The acute thromboembolus was extended to the proximal segmental artery where the feeding artery originated. Anticoagulation was started, but on the fifth day of admission, the patient complained of left side weakness and brain magnetic resonance imaging revealed an acute infarction in the right lateral thalamus. This situation could lead to a dilemma between the risk of thrombus migration during catheter manipulation in PAVM embolization and another embolic event due to the late occlusion of the shunt during anticoagulation. This complex situation was successfully managed with delayed endovascular embolization for PAVM after four months of anticoagulation. The cause of PE in this patient was eventually diagnosed as antiphospholipid syndrome (APS).ConclusionThe authors reported a rare case of APS-induced PE in the PAVM feeding artery course that led to stroke during hospitalization. We successfully treated this patient with delayed endovascular embolization for PAVM after anticoagulation for PE and stroke. It is thought to be valuable in deciding for a treatment plan for this rare condition.

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.

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.

Complex, Isolated Pulmonary Arteriovenous Malformation in Two Children With Severe Cyanosis.

2021 ◽  
pp. 215013512110535
Author(s):  
Iyad AL-Ammouri ◽  
Alexander Rabadi ◽  
Sufian Abdel Hafez ◽  
Raed Al-Taher ◽  
Amjad Bani Hani ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Exercise Intolerance ◽  
Pulmonary Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformations ◽  
Segmental Artery ◽  
Anatomical Features ◽  
Surgical Ligation

We present two cases of Isolated complex pulmonary arteriovenous malformations in two children presenting with cyanosis and exercise intolerance. We present the anatomical features and the management of each case. One patient was treated with surgical ligation of the draining vein, and one patient was treated percutaneously by closure of the feeding segmental artery.

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
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