Abdel-Aal Ahmed Kamel, Saddekni Souheil, Underwood Edgar, Oser Rachel F, Vattoth Surgith
Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Vasc Endovascular Surg. 2012 Aug;46(6):475-9. doi: 10.1177/1538574412449909. Epub 2012 Jun 4.
We report an unusual and distinct case of innumerable bilateral pulmonary arteriovenous malformation (PAVM) in a 42-year-old patient presenting with significant right-to-left shunt resulting in severe dyspnea and with a history of stroke due to paradoxical embolization related to his PAVM. Because it was impossible to treat all his PAVMs, our aim was to treat those with a feeding artery measuring 3 mm or more in diameter, aiming to improve the patient's dyspnea and decrease the risk of paradoxical embolization. We safely and successfully embolized 8 of the patient's PAVMs, using a single Amplatzer vascular plug for each PAVM. The procedure did not result in significant improvement of the patient's symptoms. In similar cases with innumerable PAVMs, the expectations of symptom relief should be lowered and the patient should be informed that treatment will only offer protection from paradoxical embolization. To our knowledge, there are no similar cases previously described in the literature.
我们报告了一例不同寻常且独特的病例，一名42岁患者患有无数双侧肺动静脉畸形（PAVM），存在明显的右向左分流，导致严重呼吸困难，并且有因与PAVM相关的反常栓塞而发生中风的病史。由于无法治疗其所有的PAVM，我们的目标是治疗那些供血动脉直径达3毫米或更大的病变，旨在改善患者的呼吸困难并降低反常栓塞的风险。我们使用单个Amplatzer血管封堵器对该患者的8处PAVM进行了安全且成功的栓塞。该操作并未使患者症状得到显著改善。在患有无数PAVM的类似病例中，应降低对症状缓解的期望，并应告知患者治疗仅能预防反常栓塞。据我们所知，此前文献中未描述过类似病例。
