Pulmonary arteriovenous malformation

Case contributed by Dr Andrew Lawson

Presentation

Family history of HHT.

Patient Data

Age: 18
Gender: Female
Modality: CT

There is a lobulated non-calcified nodule within the posterolateral aspect of the left lower lobe, which measures 9 x 12 mm. This is associated with a dilated pulmonary vein, and would be consistent with a pulmonary AVM.

Modality: DSA (angiography)
The lateral left lower lobe pulmonary arteriovenous malformation demonstrates a central varix of 9 mm in diameter, complex morphology with 2 major branches feeding the varix with high flow arteriovenous shunting, but with subsegmental further branches. For this reason, a microcatheter coaxial approach was taken, with coil embolisation of the main varix, 2 superior branches, and then a separate procedure into the inferior branch and separate compartment of the varix. All coils used were interlocking detachable platinum MRI compatible coils. At the end of the procedure, there was complete angiographic obliteration of the varix, and of arteriovenous shunting.

Case Discussion

pulmonary arteriovenous malformations (PAVM) is a rare vascular abnormality of the lung. Most cases tend to be simple AVM's (single feeding artery) although up to 20% of cases can have complex (2 or more) feeding vessels
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Case Information

rID: 25293
Case created: 18th Oct 2013
Last edited: 12th Dec 2016
Systems: Chest, Vascular
Tag: refs
Inclusion in quiz mode: Included

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