Detachable coiling for embolotherapy of high-flow pulmonary arteriovenous malformation: Case report and review of the literature

Abstract

Pulmonary arteriovenous malformations (PAVMs) are very rare anomalies of the lung parenchyma. Although many patients are asymptomatic, it carries a high risk of severe cerebral complications, and rarely fatal outcome due to rupture of the malformation. There is a strong association with the Rendu-Osler-Weber disease. The patients should be treated in case of symptomatic PAVMs (paradoxical emboli), and also preventively, when the feeding artery is at least 3 mm in diameter. Embolization is a well-established treatment, which can be very challenging when dealing with very high-flow fistulas, where there is a risk of inadvertent migration of the embolization material in the left cavities of the heart and in the aorta. This report emphasizes the importance of the diagnosis and the embolization indication in pulmonary arteriovenous malformations, and the usefulness of detachable coils in case of high-flow fistulas.