Embolotherapy of large pulmonary arteriovenous malformation

We report a rare case of a large pulmonary arteriovenous malformation of the left lung in a young female patient, successfully managed with coils embolization. A young 45-year female patient was referred at our department due to cyanosis, clubbing and exertional dyspnea noted during a routine evaluation. Gas analysis showed pH 7.38, pO2 73.3 mmHg, pCO2 38.4 mmHg. The patient first underwent a complete diagnostic radiological work-up with chest X-rays and CT-angiography; preliminary pulmonary digital subtraction angiography was performed and revealed a large vessel feeding a large arteriovenous fistula 4 × 5 cm, occupying the lower lobe of the left lung. Feeding vessels were embolized with platinum coils. Blood saturation improved from 85% preoperatively to 97% postoperatively. She was discharged uneventful the day after. Embolotherapy provides potential advantages over surgical intervention, including lower invasiveness, postprocedural pain and morbidity, and shorter hospital stays.