Pulmonary Arteriovenous Malformations

Brian Funaki, MD

Professor and Chief Vascular and Interventional Radiology

University of Chicago Medicine

A 56-year-old woman newly diagnosed with hereditary hemorrhagic telangiectasia was found to have multiple pulmonary arteriovenous malformations.
Patients with this disorder can suffer brain abscess, stroke, and myocardial infarction from paradoxic emboli to the systemic circulation.
Four LOBOs were deployed with immediate and complete occlusion of the PAVMs.
The LOBO device has excellent radial strength and an overall geometry that enables precise deployment and prevents migration through the malformation.
Following embolization, the patient remained asymptomatic and was discharged 2 hours after the procedure to home.
A CTA was obtained 6 months after PAVM embolization showing complete and durable occlusion of multiple malformations.

Figure 1: Digital subtraction angiogram showing 4 PAVMs in the right lower lobe (red arrows).

Figure 2: Angiogram showing deployed LOBO-5 completely occluding PAVM.

Figure 3: Digital subtraction pulmonary angiogram showing complete occlusion of all 4 PAVMs.

Vascular plugs have advantages over coils and are preferred as the embolic of choice of many interventional radiologists treating patients with these lesions. The LOBO device has many desirable attributes including immediate occlusion, flexible sizing, precise placement, radial strength to preclude migration, and excellent trackability in tortuous vessels.