PMC3738339_01
Case 1. A 31-year-old woman. Primary examination. (a) Right pulmonary angiography shows a big pulmonary arteriovenous malformation (PAVM) in the middle lobe and a small one in the lower lobe with a feeding artery of 1.6 mm (arrows). (b) Left pulmonary angiography shows a very small PAVM in the upper lobe with a feeding artery of 1.5 mm (arrow)
10.1258_arsr.2012.120001-fig1.jpg
PMC3738339_01_10.1258_arsr.2012.120001-fig1.jpg
ARSR-12-0001F1
One big simple PAVM and two small PAVMs were visualized by pulmonary angiography (Fig. 1a and b).
Case 1 after embolization of the big PAVM in the middle lobe with use of a detachable balloon (arrow)
10.1258_arsr.2012.120001-fig2.jpg
PMC3738339_01_10.1258_arsr.2012.120001-fig2.jpg
ARSR-12-0001F2
The big PAVM in right middle lobe was embolized with one detachable silicone balloon (Target Therapeutics, Fremont, CA, USA) (Fig. 2) while the two small ones were left untreated because of small feeders <3 mm.
Case 1. Pulmonary angiography at 8-year follow-up. (a) The feeding artery to the PAVM in the right lower lobe had grown to 2.7 mm. (electronic measurement); (b, c) after embolization with two 3-5 mm vortex coils (Boston Scientific)
10.1258_arsr.2012.120001-fig3.jpg
PMC3738339_01_10.1258_arsr.2012.120001-fig3.jpg
ARSR-12-0001F3
The feeders of the other two PAVMs had since the initial pulmonary angiogram 8 years earlier grown from 1.6 mm to 2.7 mm (right lower lobe) (Fig. 3) and from 1.5 mm to 2.0 mm (left upper lobe) (Fig. 4a). The right sided PAVM was embolized using two vortexes - 35, 3-5 mm, 0.035 coils (Boston Scientific/Target Vascular, La Garenne-Colombes, Cedex, France) (Fig. 3b and c), and the left with one 3/30 mm coil (MR eye, non-ferro-magnetic standard embolization coil 0.035, Cook, Bjaeverskov, Denmark) (Fig. 4b).
Case 1 at 8-year follow-up. (a) The feeding artery to the PAVM in left upper lobe had grown to 2.0 mm (electronic measurement); (b) after embolization using one 3/30 mm coil (Cook, Denmark)
10.1258_arsr.2012.120001-fig4.jpg
PMC3738339_01_10.1258_arsr.2012.120001-fig4.jpg
ARSR-12-0001F4
The feeders of the other two PAVMs had since the initial pulmonary angiogram 8 years earlier grown from 1.6 mm to 2.7 mm (right lower lobe) (Fig. 3) and from 1.5 mm to 2.0 mm (left upper lobe) (Fig. 4a). The right sided PAVM was embolized using two vortexes - 35, 3-5 mm, 0.035 coils (Boston Scientific/Target Vascular, La Garenne-Colombes, Cedex, France) (Fig. 3b and c), and the left with one 3/30 mm coil (MR eye, non-ferro-magnetic standard embolization coil 0.035, Cook, Bjaeverskov, Denmark) (Fig. 4b).
PMC3738339_02
Case 2. A 37-year-old woman with complex PAVM with two feeding arteries in left lower lobe
10.1258_arsr.2012.120001-fig5.jpg
PMC3738339_02_10.1258_arsr.2012.120001-fig5.jpg
ARSR-12-0001F5
At pulmonary angiography it appeared to be a complex PAVM (Fig. 5) with two feeding arteries: one was 4.4 mm in size (Fig. 6) and the other was 2 mm (Fig. 7).
Case 2. The biggest feeding artery measured 4.4 mm in diameter (electronic measurement) and was embolized with an 8 mm Amplatzer vascular plug 4 through a 5F vertebral catheter
10.1258_arsr.2012.120001-fig6.jpg
PMC3738339_02_10.1258_arsr.2012.120001-fig6.jpg
ARSR-12-0001F6
At pulmonary angiography it appeared to be a complex PAVM (Fig. 5) with two feeding arteries: one was 4.4 mm in size (Fig. 6) and the other was 2 mm (Fig. 7).