先天性膈下动脉-肺动静脉畸形的血管内栓塞治疗：一例罕见病例报告。
Endovascular embolization of a congenital inferior phrenic artery-to-pulmonary arteriovenous malformation: a rare case report.
机构信息
Department of Interventional Radiology, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, No. 1558 North Third Ring Road, Hangzhou, Zhejiang, China.
Department of Radiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, No. 507 Zhengmin Road, Shanghai, 200433, China.
出版信息
BMC Pulm Med. 2024 Oct 14;24(1):513. doi: 10.1186/s12890-024-03324-y.
BACKGROUND
Pulmonary arteriovenous malformation (PAVM) is abnormal arteriovenous shunts between pulmonary artery (PA) and pulmonary vein, and rarely has congenital direct communications with systemic arteries.
CASE PRESENTATION
A 33-year-old male presented to our hospital with intermittent bloody sputum with no evidence of pulmonary infection, trauma or surgery. Chest computed tomography angiography (CTA) indicated the congenital inferior phrenic artery (IPA)-to-PAVM surrounded by diffuse alveolar hemorrhage located in the lower lobe of right lung. Both the afferent PA and IPA were successfully embolized with coils. Recurrent hemoptysis did not occur during one-year follow up.
CONCLUSIONS
The congenital communication between IPA and PAVM is rare, and the abnormal direct shunt would induce hemodynamically unstable condition within PAVM. Endovascular embolization of the afferent PA and IPA is a safe and effective method for this abnormal congenital shunt in lung.
背景
肺动静脉畸形（PAVM）是肺动脉（PA）和肺静脉之间异常的动静脉分流，很少与体循环动脉有先天性直接交通。
病例介绍
一名 33 岁男性因间歇性咯血就诊，无肺部感染、外伤或手术史。胸部计算机断层血管造影（CTA）显示先天性膈下动脉（IPA）-PAVM 先天性畸形，周围伴有弥漫性肺泡出血，位于右肺下叶。通过线圈成功栓塞了入肺动脉和膈下动脉。在一年的随访中，没有再发生咯血。
结论
IPA 和 PAVM 之间的先天性交通很罕见，异常的直接分流会导致 PAVM 内血流动力学不稳定。PA 和 IPA 的血管内栓塞是治疗肺部这种异常先天性分流的一种安全有效的方法。
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