Therapeutic embolization of pulmonary arteriovenous malformation

A 49-year old man presented with recurrent transient ischaemic attacks and a pulmonary arteriovenous malformation (PAM) was found in his lower left lobe. Left lower lobectomy was performed, and the attacks ceased. However, 18 months later, a fresh PAM was detected in the right lower lobe. In order to avoid further lung resection, therapeutic embolization with metal-dacron coils and gelfoam was performed, resulting in complete occlusion of the PAM. The patient remained well at follow-up 6 months later. Therapeutic embolization is an effective alternative to surgery in the treatment of PAM, especially in the presence of multiple lesions when it is important to conserve functional lung tissue.