A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment
Masiello Rossella,
Iadevaia Carlo,
Grella Edoardo,
Tranfa Carmelindo,
Cerqua Francesco,
Rossi Giovanni,
Santoro Giuseppe,
Amato Bruno,
Rocca Aldo,
De Dona Roberta,
Lavoretano Sabrina,
Perrotta Fabio
Affiliations
Masiello Rossella
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy Giovanni Rossi: U.O.C. Radiology A.O.R.N dei Colli – Monaldi Hospital, Naples, Italy
Iadevaia Carlo
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Grella Edoardo
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Tranfa Carmelindo
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Cerqua Francesco
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Rossi Giovanni
U.O.C. Radiology A.O.R.N dei Colli – Monaldi Hospital, Naples, Italy
Santoro Giuseppe
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Amato Bruno
Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
Rocca Aldo
Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
De Dona Roberta
Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
Lavoretano Sabrina
Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, Campobasso, Italy
Perrotta Fabio
Department of Cardio- Thoracic and Respiratory Sciences – Second University of Naples - Monaldi Hospital, Naples, Italy
Pulmonary arteriovenous Malformations (PAVMs) are a rare vascular alteration characterized by abnormal communications between the pulmonary arteries and veins resulting in an extracardiac right-to-left (R-L) shunt. The majority of PAVMs are associated with an autosomal dominant vascular disorder also known as Osler-Weber- Rendu Syndrome. PAVMs appearance can be both single and multiple. Clinical manifestations include hypoxemia, dyspnea cyanosis, hemoptysis and cerebrovascular ischemic events or abscesses. We report a case of an 18 year old female with severe respiratory failure caused by a relapse of multiple unilateral pulmonary arterovenous fistula. Symptoms at admission include dyspnea, cyanosis and clubbing. The patient underwent pulmonary angio-TC scan, brain CT and echocardiography. The thoracic angio-CT scan showed the presence of PAVMs of RUL and RLL; a marked increase of right bronchial artery caliber and its branches with an aneurismatic dilatation was also observed. The patient underwent percutaneous transcatheter embolization using Amplatzer Vascular Plug IV; a relevant clinical and functional improvement was subsequently recorded. Embolization is effective in the treatment of relapsing PAVMS.
