PMC5368875_01
Thoracic angio-CT scan at admission shows: presence of multiple AV Fistulas of RUL and RLL, increase of pulmonary venous and right bronchial artery and its branches caliber associated to aneurismatic dilatation of 1 cm. Web-like appearances are evident in the superior segment of RUL. Transversal (a) and Coronal (b) view.
med-2015-0087f1.jpg
PMC5368875_01_med-2015-0087f1.jpg
f1-med-2015-0087
The thoracic angio-CT scan showed the presence of Multiple Artero-Venous Fistulas (MAVFs) of Right Upper Lobe (RUL) and Right Lover Lobe (RLL) with an increase of pulmonary venous caliber compared to left lung field; a marked increase of right bronchial artery caliber and its branches was also observed in addition to an aneurismatic dilatation of 1 cm not previously detected; Web-like appearance was evident in the superior segment of RUL (Figure 1).
Embolization procedures using the Amplatzer Vascular Plug IV (8 devices) as well as insertion of Amplatzer Vascular Plug IV (2 device) within the systemic-pulmonary bridge.
med-2015-0087f2.jpg
PMC5368875_01_med-2015-0087f2.jpg
f2-med-2015-0087
Jude Medical, Saint Paul - Mn, USA) devices within the systemic-pulmonary bridge (Figure 2).
Thoracic angio-CT after embolization. Transversal (a) and Coronal (b) view.
med-2015-0087f3.jpg
PMC5368875_01_med-2015-0087f3.jpg
f3-med-2015-0087
Thoracic angio-CT scan carried out six months post-embolization showed a substantial normalization of the arteriovenous morphology within the right lobes without bronchial pseudo aneurysm; enlargement of some vessels of ventral segment of RUL and few peripheral MAVFs persisted at the level of the superior segment of the RLL (Figure 3).