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Pulmonary embolism following embolization of an arteriovenous malformation
1Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
Insights
A pediatric patient experienced a severe brain bleed from an arteriovenous malformation (AVM). Accidental N-butyl cyanoacrylate (NBCA) embolization during AVM treatment caused pulmonary complications, requiring careful management.
Area of Science:
- Neurology
- Pediatric Neurosurgery
- Interventional Radiology
Background:
- Arteriovenous malformations (AVMs) can cause severe intracranial hemorrhage, particularly in pediatric patients.
- Embolization using N-butyl cyanoacrylate (NBCA) is a treatment option for AVMs.
- Complications such as accidental pulmonary embolization can occur during NBCA embolization.
Abstract:
The case of a 12-year-old girl who suffered a severe intracranial bleed secondary to a large arteriovenous malformation (AVM) is described. Following investigation the appropriate treatment was considered to be embolization of the AVM, under general anaesthesia, using N-butyl cyanoacrylate (NBCA). During the procedure acute desaturation and pulmonary oedema occurred secondary to accidental pulmonary embolization with NBCA. The management of the procedure and subsequent clinical course is reported and available literature reviewed.