[Pulmonary embolism by cyanoacrylate following embolisation of an arteriovenous malformation].

INTRODUCTION

Symptomatic complications can occur after intravascular injection of cyanoacrylate glue. We report a case of pulmonary embolism following embolisation of an arteriovenous malformation (AVM).

CASE REPORT

A 46-year-old woman was found to have an internal iliac AVM which was obliterated using N-butyl-2 cyanoacrylate (NBCA) mixed with lipiodol. The early clinical course was uneventful. On the third post-operative day she complained of sudden, transient chest tightness. On admission one hour later the chest pain had disappeared. Physical examination was normal. A chest roentgenogram showed multiple, dense, branched opacities scattered throughout both lung fields which were confirmed on HRCT, suggesting diffuse scattered embolism of iodine- labelled NBCA. The radiological signs persisted 6 months later.

CONCLUSION

Endovascular treatment of arteriovenous malformations with NBCA can be responsible for symptomatic pulmonary embolism. This is not detectable radiologically in the absence of contrast medium. Radiologists should be aware of these often asymptomatic, but sometimes fatal, embolic complications.