Migrated coil expectorated 12 years after embolization of pulmonary arteriovenous malformation, due probably to abscess formation around the coil

Aya Konno-Yamamoto; Shota Yamamoto; Junko Suzuki; Takeshi Fukami; Masashi Kitani; Hirotoshi Matsui

doi:10.1016/j.rmcr.2020.101245

Migrated coil expectorated 12 years after embolization of pulmonary arteriovenous malformation, due probably to abscess formation around the coil

Respir Med Case Rep. 2020 Oct 3:31:101245. doi: 10.1016/j.rmcr.2020.101245. eCollection 2020.

Authors

Aya Konno-Yamamoto¹, Shota Yamamoto^{1

2}, Junko Suzuki¹, Takeshi Fukami³, Masashi Kitani⁴, Hirotoshi Matsui¹

Affiliations

¹ Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, 3-1-1 Takeoka, Kiyose, Tokyo, 204-8585, Japan.
² Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.
³ Department of Thoracic Surgery, National Hospital Organization Tokyo Hospital, 3-1-1 Takeoka, Kiyose, Tokyo, 204-8585, Japan.
⁴ Department of Pathology, National Hospital Organization Tokyo Hospital, 3-1-1 Takeoka, Kiyose, Tokyo, 204-8585, Japan.

Abstract

Pulmonary arteriovenous malformations (PAVMs) are rare vascular structures providing direct capillary-free communications between pulmonary arteries and veins. Embolotherapy is indicated as a front-line therapy. We report an unusual long-term complication of coil embolization for a 44-year-old woman with hereditary hemorrhagic telangiectasia (HHT) who had repeatedly undergone the procedures for her PAVMs. She expectorated the coil which had been placed 12 years earlier and migrated to the bronchus according to the chest radiogram and bronchoscopy. Histology of the resected lung segment suggested the cavity communicating with the bronchus was the consequence of abscess formation around the coils. Even after technically successful embolization to PAVMs, long term follow-up should be necessary paying attention to the symptoms and imaging to avoid massive hemoptysis and subsequent emergency surgery.

Keywords: Complication; Embolization; Hemoptysis; Hereditary hemorrhagic telangiectasia; Pulmonary arteriovenous malformations.

Publication types

Case Reports