Pulmonary Arteriovenous Malformation

Omar Chohan, DO

Vascular Interventional Radiologist

Gates Vascular Institute

A 70-year-old male with a past medical history of atrial fibrillation, DM, and HTN, presented with a PAVM. Because patient was at increased risk for stroke with AF, presence of PAVM doubled his risk for stroke. Elective PAVM embolization was offered with patient choosing to move forward with embolization.
A LOBO-5 occluder was deployed into the feeding artery with excellent accuracy.
Repeat angiography showed immediate occlusion but opacification of PAVM via a small feeding artery within the proximal feeding artery.
A second LOBO-5 was deployed with excellent accuracy and immediate occlusion on follow up angiography and completion angiography revealed no further opacification of the PAVM.
Patient had a good clinical response following the embolization.
The LOBOs were deployed exactly where it was intended to go with no migration.

Figure 1: RLL pulmonary angiogram shows PAVM with single feeding vessel and draining vessel.

Figure 2: RLL pulmonary angiography post embolization shows two LOBO-5s (brackets) within the feeding arteries with immediate occlusion and no opacification of the PAVM.

LOBO is ideal in PAVMs ensuring accurate placement and rapid occlusion with little chance for recanalization given the tight braiding and multiple disc design.