Embolization of pulmonary AVMs of feeding arteries less than 3 mm: reports of two cases and an 8-year follow-up without embolization
A 37-year-old woman, who was a member of a HHT family, had by screening been diagnosed with a PAVM in left lower lobe. At pulmonary angiography it appeared to be a complex PAVM (Fig. ) with two feeding arteries: one was 4.4 mm in size (Fig. ) and the other was 2 mm (Fig. ). It was decided to embolize both, the larger one with an Amplatzer vascular plug 4 (AGA Medical Corporation/St Jude Medical Inc., St Paul, MN, USA) and the small one with deployment of one 3/50 mm MR eye coil (COOK, Bjaeverskov Denmark). The patient had a little pleurisy for two days after the embolizaton but was well at 3-month follow-up and with a negative contrast echocardiography. Embolization of the bigger feeding artery only would have resulted in an insufficient embolization of this complex PAVM.