title: A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment.
abstract: Pulmonary arteriovenous Malformations (PAVMs) are a rare vascular alteration characterized by abnormal communications between the pulmonary arteries and veins resulting in an extracardiac right-to-left (R-L) shunt. The majority of PAVMs are associated with an autosomal dominant vascular disorder also known as Osler-Weber-Rendu Syndrome. PAVMs appearance can be both single and multiple. Clinical manifestations include hypoxemia, dyspnea cyanosis, hemoptysis and cerebrovascular ischemic events or abscesses. We report a case of an 18 year old female with severe respiratory failure caused by a relapse of multiple unilateral pulmonary arterovenous fistula. Symptoms at admission include dyspnea, cyanosis and clubbing. The patient underwent pulmonary angio-TC scan, brain CT and echocardiography. The thoracic angio-CT scan showed the presence of PAVMs of RUL and RLL; a marked increase of right bronchial artery caliber and its branches with an aneurismatic dilatation was also observed. The patient underwent percutaneous transcatheter embolization using Amplatzer Vascular Plug IV; a relevant clinical and functional improvement was subsequently recorded. Embolization is effective in the treatment of relapsing PAVMS.
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Masiello
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Iadevaia
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Grella
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Carmelindo
authors.initials: C
authors.lastname: Tranfa
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cerqua
authors.affiliation: U.O.C. Radiology A.O.R.N dei Colli - Monaldi Hospital, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Rossi
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santoro
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: De Dona
authors.affiliation: Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Lavoretano
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences - Second University of Naples - Monaldi Hospital, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Perrotta
keywords: Angio-CT Scan; Embolization; Pulmonary arteriovenous Malformations (PAVMs); Unilateral fistula