Pulmonary arteriovenous malformation exhibiting recanalization >10 years after coil embolization: Two case reports.

Abstract:

RATIONALE:Some patients with pulmonary arteriovenous malformation (PAVM) present with hypoxemia and life-threatening complications, including stroke and cerebral abscess. Catheter embolization is currently the preferred treatment for PAVM. However, previous studies have revealed that the incidence of PAVM recanalization is approximately 10% 5 to 7 years after embolization. In contrast, there are no studies where recanalization has occurred over 10 years after embolization. PATIENT CONCERNS:Herein, we report 2 cases diagnosed with cerebral embolism due to PAVM recanalization 13 years and 30 years after catheter treatment, in case I and II, respectively. DIAGNOSES:Both cases were diagnosed with PAVM recanalization on chest computed tomography (CT) examination performed after cerebral embolism development. Furthermore, pulmonary artery angiography revealed blood flow from the pulmonary artery to the vein in the PAVM, confirming PAVM recanalization. INTERVENTIONS:Coil re-embolization was performed for the all recanalized PAVM. OUTCOMES:All the target lesions were successfully re-embolized in both cases. However, in case I, the second recanalization of embolized PAVM was confirmed 1 year after coil re-embolization. Consequently, the third embolization was performed in case I. In contrast to case I, the patient in case II was followed up without recanalization for 2 years after embolization. LESSONS:We described the first 2 cases diagnosed with PAVM recanalization >10 years after the first catheter embolization. These cases suggest that patients with PAVMs should undergo life-long follow-up after catheter embolization.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Takao S,Masuda T,Yamada T,Yamaguchi K,Sakamoto S,Matsushima H,Horimasu Y,Nakashima T,Miyamoto S,Iwamoto H,Fujitaka K,Hamada H,Hattori N

doi

10.1097/MD.0000000000018694

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

e18694

issue

2

eissn

0025-7974

issn

1536-5964

pii

00005792-202001100-00061

journal_volume

99

pub_type

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