Kataoka K, Matsuura M, Seno N
Department of Respiratory Surgery, Hiroshima City Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1994 Jul;42(7):1082-6.
Three cases of arteriovenous malformation (AVM) of the lung are presented. The first patient was 36-year-old female and the second was 25-year-old male, and both with asymptomatic bilateral multiple small AVMs. We used coil spring occlusion in therapeutic transcatheter embolization of the AVMs. A pulmonary arteriogram confirmed the completely occluded AVMs. The another patient was 21-year-old female whose lips and nails were cyanotic. She had clubbing fingers and vascular murmur was audible on her chest wall. The laboratory examination revealed polycythemia and hypoxemia. A pulmonary angiogram revealed a single large AVM which was composed of a feeding artery (A9) and a draining vein (dilated basal pulmonary vein). We performed a left basal segmentectomy and postoperative course was uneventful. Transcatheter embolization is useful for the case of multiple or peripheral or small AVM of the lung, but the case of large solitary AVM with rapid blood flow is thought to be an indication for the operation. These two therapeutic modality should be selected case by case.
本文报告3例肺动静脉畸形（AVM）。首例患者为36岁女性，第二例为25岁男性，二者均为无症状的双侧多发性小AVM。我们在AVM的治疗性经导管栓塞中使用了弹簧圈栓塞。肺动脉造影证实AVM完全闭塞。另一例患者为21岁女性，嘴唇和指甲发绀。她有杵状指，胸壁可闻及血管杂音。实验室检查显示红细胞增多症和低氧血症。肺动脉造影显示一个单一的大AVM，由一条供血动脉（A9）和一条引流静脉（扩张的肺基底静脉）组成。我们进行了左肺基底段切除术，术后过程顺利。经导管栓塞术适用于肺多发性或周边性或小AVM的病例，但对于大的孤立性AVM且血流快速的病例，手术被认为是一种治疗选择。这两种治疗方式应根据具体情况逐一选择。
