Kaneko N, Yamada M, Ohtsuka H, Akizawa T, Narushima M, Tanaka K, Osakabe Y, Suzuki H, Noguchi E, Suzuki S
Department of Respiratory Internal Medicine, Showa University, Fujigaoka Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Jan;31(1):84-7.
A case of pulmonary arteriovenous fistulas (PAVF) treated with detachable balloon embolotherapy is reported. A 31-year-old man was admitted to hospital because of polycythemia and hypoxemia. He had a history of dyspnea on exertion and transient cerebral ischemic attacks (TIA). Chest roentgenogram revealed a peripheral lobulated lesion in the right upper lung field and a coin lesion in the left lung field connected by dilated blood vessels to each hilus. Pulmonary angiography and right heart catheterization was performed. Four PAVFs were observed in bilateral lung field, and the intrapulmonary shunt ratio was 25.8%. Because the patient was symptomatic, we embolized each PAVF with a detachable balloon without complications. After embolotherapy, there was improvement in his symptoms. hypoxemia and shunt ratio. Recent reviews have highlighted the need to consider embolotherapy for bilateral multiple PAVF. We conclude that embolotherapy with detachable balloon is a very useful procedure for treatment of bilateral multiple PAVF.
报告了一例采用可脱性球囊栓塞疗法治疗的肺动静脉瘘（PAVF）病例。一名31岁男性因红细胞增多症和低氧血症入院。他有劳力性呼吸困难和短暂性脑缺血发作（TIA）病史。胸部X线片显示右上肺野有一个周边分叶状病变，左肺野有一个硬币状病变，通过扩张的血管与各肺门相连。进行了肺血管造影和右心导管检查。在双侧肺野观察到4个PAVF，肺内分流率为25.8%。由于患者有症状，我们用可脱性球囊对每个PAVF进行栓塞，无并发症发生。栓塞治疗后，患者的症状、低氧血症和分流率均有改善。最近的综述强调了对双侧多发性PAVF考虑采用栓塞疗法的必要性。我们得出结论，可脱性球囊栓塞疗法是治疗双侧多发性PAVF的一种非常有用的方法。
