Open AccessPulmonary arteriovenous malformation exhibiting recanalization >10 years after coil embolization
Author(s) -
Shun Takao,
Takeshi Masuda,
Takahiro Yamada,
Kakuhiro Yamaguchi,
Shinjiro Sakamoto,
Hayato Matsushima,
Yasushi Horimasu,
Taku Nakashima,
Shintaro Miyamoto,
Hiroshi Iwamoto,
Kazunori Fujitaka,
Hironobu Hamada,
Noboru Hattori
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000018694
Subject(s) - medicine , embolization , radiology , catheter , angiography , embolism , intracranial embolism , pulmonary embolism , pulmonary artery , surgery
Rationale: Some patients with pulmonary arteriovenous malformation (PAVM) present with hypoxemia and life-threatening complications, including stroke and cerebral abscess. Catheter embolization is currently the preferred treatment for PAVM. However, previous studies have revealed that the incidence of PAVM recanalization is approximately 10% 5 to 7 years after embolization. In contrast, there are no studies where recanalization has occurred over 10 years after embolization. Patient concerns: Herein, we report 2 cases diagnosed with cerebral embolism due to PAVM recanalization 13 years and 30 years after catheter treatment, in case I and II, respectively. Diagnoses: Both cases were diagnosed with PAVM recanalization on chest computed tomography (CT) examination performed after cerebral embolism development. Furthermore, pulmonary artery angiography revealed blood flow from the pulmonary artery to the vein in the PAVM, confirming PAVM recanalization. Interventions: Coil re-embolization was performed for the all recanalized PAVM. Outcomes: All the target lesions were successfully re-embolized in both cases. However, in case I, the second recanalization of embolized PAVM was confirmed 1 year after coil re-embolization. Consequently, the third embolization was performed in case I. In contrast to case I, the patient in case II was followed up without recanalization for 2 years after embolization. Lessons: We described the first 2 cases diagnosed with PAVM recanalization >10 years after the first catheter embolization. These cases suggest that patients with PAVMs should undergo life-long follow-up after catheter embolization.