Document Type : Case Report
Authors
1 Associate Professor, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
3 Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: Endovascular coil embolization is an approved treatment for pulmonary arteriovenous malformation (AVM) but it brings high rate of thromboembolic complications with subsequent morbidity and mortality. Hereby, we report two cases of AVM coil embolization and management of their compilations. CASE REPORT: The first case was a 57-year-old male with five implanted coils in the lower lobe of right lung in which two of them were migrated soon after implantation. On exploration, a large atrial septal defect was detected and then repaired successfully. The next day, he was transferred for fluoroscopy. Two embolized coils were found at the site of the left iliac artery which was extracted via snare through sheath implanted in the left femoral artery. Coil migration to the left atrium and subsequently to the left iliac artery is reported for the first time. The second case was a 45-year-old male with central cyanosis and clubbing of upper and lower extremities from childhood. On computed tomography angiography (CTA), a vascular lesion was found. The patient underwent coil embolization for closure of AVM. The patient was still symptomatic after successful closure of AVM. On CTA, two feeding arteries were detected. He underwent second coil embolization procedure. CONCLUSION: AVM coil embolization is a temptative procedure, which should be performed on its real indications by an expert centers who can handle complications of this procedure. The performance of CTA seems beneficial in some cases to confirm complete embolization of AVM.
Keywords
- Lee BB, Lardeo J, Neville R. Arterio-venous malformation: how much do we know? Phlebology 2009; 24(5): 193-200.
- Gloviczki P. Handbook of venous disorders: Guidelines of the American venous forum. Boca Raton, FL: CRC Press; 2008.
- Nakajima J, Takamoto S, Takeuchi E, Fukami T, Sano A. Thoracoscopic surgery for pulmonary arteriovenous malformation. Asian Cardiovasc Thorac Ann 2006; 14(5): 412-5.
- Lee BB, Baumgartner I, Berlien HP, Bianchini G, Burrows P, Do YS, et al. Consensus document of the international union of angiology (IUA)-2013. Current concept on the management of arterio-venous management. Int Angiol 2013; 32(1): 9-36.
- Khurshid I, Downie GH. Pulmonary arteriovenous malformation. Postgrad Med J 2002; 78(918): 191-7.
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