Successful embolization of a clinically significant pulmonary arteriovenous malformation

The authors present the clinical case of a 59-year-old female patient with a history of peripheral desaturation, which was detected in the perioperative period 4 years earlier. She reported exertional dyspnea, quantified as grade 2 on the Modified Medical Research Council (mMRC) Dyspnea Scale (walks slower than people of the same age because of dyspnea or has to stop for breath when walking at her own pace), and morning cough with mucoid sputum and denied platypnea, epistaxis, telangiectasias and hemoptysis. A computed chest tomography scan revealed a contrast-enhanced lesion on the right upper lobe with an afferent and two efferent vessels compatible with pulmonary arteriovenous malformation. The transesophageal echocardiogram revealed an important right-left shunt compatible with arteriovenous fistula in the pulmonary circulation. An angiography confirmed the diagnosis and a selective embolization of the afferent artery was performed with resolution of symptoms. We present the clinical case of a 59-year-old female patient with dyspnoea and a history of peripheral desaturation, which was detected in the perioperative period 4 years earlier. Although she didn't present any typical symptoms such as platypnea, epistaxis, telangiectasias or hemoptysis, the chest-CT scan was compatible with the diagnosis of pulmonary arteriovenous malformation. An angiography confirmed the diagnosis and a selective embolization of the afferent artery was performed with resolution of symptoms. image