Endovascular Management of Massive Hemoptysis Secondary to Systemic Collaterals in Previously Treated Pulmonary Arteriovenous Malformation

Abstract

Pulmonary arteriovenous malformations (PAVMs) are abnormal connections between pulmonary artery and vein through a thin-walled aneurysmal sac, leading to a right-to-left shunt. These are commonly associated with hereditary hemorrhagic telangiectasia, and treatment guidelines have been set on how to approach their management. Incorrect proximal placement of an embolization device can lead to delayed recruitment of systemic collaterals leading to presentation with hemoptysis. We are presenting a case of a 17-year-old male with treated PAVMs and with fresh hemoptysis. In this case report, we attempt to explain the management of such a complication and follow the principles of arteriovenous malformation embolization on the left side.

Keywords

pulmonary arteriovenous malformation hereditary hemorrhagic telangiectasia systemic collaterals vascular plug coils

Get full access to this article

View all access options for this article.

References

Brillet

Dumont

Bouaziz

et al. Pulmonary arteriovenous malformation treated with embolotherapy: systemic collateral supply at multidetector CT angiography after 2-20-year follow-up. Radiology. 2007;242(1):267–276.

Trerotola

Pyeritz

. PAVM embolization: an update. AJR Am J Roentgenol. 2010;195(4):837–845.

Chamarthy

Park

Sutphin

et al. Pulmonary arteriovenous malformations: endovascular therapy. Cardiovasc Diagn Ther. 2018;8(3):338–349.

White

RIJ

Lynch-Nyhan

Terry

et al. Pulmonary arteriovenous malformations: techniques and long-term outcome of embolotherapy. Radiology. 1988;169(3):663–669.

Faughnan

Palda

Garcia-Tsao

et al. International guidelines for the diagnosis and management of hereditary haemorrhagic telangiectasia. J Med Genet. 2011;48(2):73–87.