In Reply to: Case 0400_03 -- Embolization of Systemically Supplied Pulmonary Arteriovenous Malformations posted by Editor on April 04, 2000 at 17:07:38:
This is a real weirdo. Do these abnromal arteries really reprsent part of a PAVM. They look more like arterio-pulmonary collaterals of the type which are seen in cyantic congenital heart disease (MAPCAs). In those circumsyances balloon or coil embolization is appropriate either before (for small MAPCAs) or after (for larger MAPCAs which are maintaining oxygnetion) - this has been well written up elsewhere (Mitchell SE, Kan JS, White RI. Interventional techniques in congenital heart disease. Seminars in Roentgenology 1985;20:290-311; Hartnell GG. Interventional Procedures in Cardiac Radiology II. Non-coronary Interventions. Journal of Interventional Radiology 1993;8:17-27).
In view of the previous occlusion of the IVC does this represent the end result of thromboembolic disease?? with MAPCAs developing during recurrent PEs which have subsequently resolved to produce a normal pulmonary arteriogram. My feeling and experience fron treating MAPCAs in the context of cyanotic congenital heart disease is that coils alone are good enough and histacryl etc is not required.