Occlusion of pulmonary arteriovenous fistula using vascular plug in a patient with previous paradoxal cerebral embolism

Abstract

Percutaneous transcatheter embolization has become the treatment of choice for pulmonary arteriovenous fistulae (PAVFs), replacing surgical intervention in most cases. Classical devices, such as intravascular coils and detachable balloons, have proven to be successful for percutaneous occlusions of small or medium-sized PAVFs; however, they are not ideal for larger and high flow fistulae due to the risk of embolization to systemic circulation. The case of a 49-year-old woman with high flow pulmonary fistula and previous neurological ischemic manifestations undergoing successful transcatheter closure with an AmplatzerTM Vascular Plug II, a device designed for occlusion of vascular abnormalities, is reported.

Arteriovenous fistula; Pulmonary artery; Embolization, therapeutic; Coronary occlusion