Pulmonary arteriovenous fistula complicated by venous thromboembolism and paradoxical cerebral infarction during early pregnancy

BMJ Case Rep. 2018 Feb 6:2018:bcr2017222519. doi: 10.1136/bcr-2017-222519.

Abstract

A 39-year-old Japanese woman was diagnosed with a pulmonary arteriovenous fistula (PAVF) complicated by paradoxical cerebral infarction during pregnancy. She received an inferior vena cava filter (IVCF), but it was difficult to indwell because of the risk of repeat thromboembolism via PAVF. Therefore, we temporarily occluded the pulmonary artery with a balloon to prevent free thrombi from reaching the IVCF. Detection and treatment of PAVF are recommended in fertile young women. Obstruction of the pulmonary artery trunk with a balloon catheter may be useful during IVCF removal in patients with untreated PAVF.

Keywords: interventional radiology; medical management; pulmonary embolism.

Publication types

  • Case Reports

MeSH terms

  • Abortion, Induced
  • Adult
  • Anticoagulants / therapeutic use*
  • Arteriovenous Fistula / diagnostic imaging*
  • Arteriovenous Fistula / pathology
  • Arteriovenous Fistula / surgery
  • Balloon Occlusion / methods*
  • Female
  • Humans
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnostic imaging*
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Pregnancy Complications, Cardiovascular / surgery
  • Pregnancy Trimester, First
  • Pulmonary Artery / abnormalities*
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology
  • Pulmonary Artery / surgery
  • Pulmonary Veins / abnormalities*
  • Pulmonary Veins / diagnostic imaging
  • Pulmonary Veins / pathology
  • Pulmonary Veins / surgery
  • Treatment Outcome
  • Vena Cava Filters
  • Venous Thromboembolism / complications
  • Venous Thromboembolism / diagnostic imaging*
  • Venous Thromboembolism / surgery

Substances

  • Anticoagulants

Supplementary concepts

  • Pulmonary Arteriovenous Fistulas