case_images: PMC6319526_01
case_images: a Baseline pulmonary digital subtraction angiography in a 52-year-old woman, affected by HHT, with several small PAVMs. b The biggest of these was located in the left lower lobe, with a feeding artery of 3 mm
case_images: 42155_2018_27_Fig1_HTML.jpg
case_images: PMC6319526_01_42155_2018_27_Fig1_HTML.jpg
case_images: Fig1
case_images: The left pulmonary artery was catheterised, and angiography depicted the PAVM (Fig. 1a, b).
case_images: a After coil deployment, there was still flow in PAVM. b and c An additional MVP-3Q was deployed, and the flow stopped immediately
case_images: 42155_2018_27_Fig2_HTML.jpg
case_images: PMC6319526_01_42155_2018_27_Fig2_HTML.jpg
case_images: Fig2
case_images: It was decided to deploy an MVP-3Q (Reverse Medical Corporation, Irvine CA, USA) through a 2.4 Fr microcatheter (Renegade microcatheter, Boston ScientificMarlborough, MA, USA) with following immediate occlusion (Fig. 2a-c).
case_images: PMC6319526_02
case_images: a A 19-year-old woman with HHT. Small PAVM with feeding artery 3.2 mm in the right upper lobe. b Previous embolization with coils of complex PAVM in the same lobe
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case_images: PMC6319526_02_42155_2018_27_Fig3_HTML.jpg
case_images: Fig3
case_images: The right pulmonary artery was catheterized, and angiography depicted two PAVMs, one in a right upper lobe and one in the right lower lobe (Fig. 3a, b).
case_images: a Before deployment of MVP-5Q. b After deployment of MVP-5Q, immediate stop of flow
case_images: 42155_2018_27_Fig4_HTML.jpg
case_images: PMC6319526_02_42155_2018_27_Fig4_HTML.jpg
case_images: Fig4
case_images: The PAVM located in the upper lobe was engaged coaxially with microcatheter 2.8 Fr (Renegade Hi-Flo; Boston ScientificMarlborough, MA, USA) and primarily embolized with MVP-5Q (Reverse Medical Corporation, Irvine CA, USA) with following immediate occlusion (Fig. 4 a, b).
case_images: PMC6319526_03
case_images: Non-contrast CT showed a simple PAVM in right upper lobe with feeding artery of 3, 3 mm in diameter
case_images: 42155_2018_27_Fig5_HTML.jpg
case_images: PMC6319526_03_42155_2018_27_Fig5_HTML.jpg
case_images: Fig5
case_images: CE confirmed shunt grade II-III and non-contrast CT showed two PAVMs, one located in the right lower lobe with feeding artery of 5 mm and the other with feeding artery of 3.3 mm in diameter located in the right upper lobe (Fig. 5).
case_images: Pulmonary angiography before and after embolization of both PAVMs in the right lung. The PAVM in upper lobe was embolized with MVP-5Q
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case_images: PMC6319526_03_42155_2018_27_Fig6_HTML.jpg
case_images: Fig6
case_images: The PAVM in the upper lobe was embolized with MPV-5Q (Reverse Medical Corporation, Irvine CA, USA) delivered through a microcatheter 2.8 Fr (Renegade Hi-Flo; Boston ScientificMarlborough, MA, USA) with following immediate occlusion of both PAVMs (Fig. 6 a, b).
case_images: PMC6319526_04
case_images: Pulmonary angiography before embolization of PAVMs in the right lung with two feeding arteries
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case_images: PMC6319526_04_42155_2018_27_Fig7_HTML.jpg
case_images: Fig7
case_images: The biggest had a feeding artery of 6 mm and was embolized with Amplatz plug IV (St Jude Medical, Minnesota, USA), 8 mm in diameter a few months before the actual intervention (Fig. 7).
case_images: The PAVM in lower lobe was embolized with detachable coil and with MVP-5Q
case_images: 42155_2018_27_Fig8_HTML.jpg
case_images: PMC6319526_04_42155_2018_27_Fig8_HTML.jpg
case_images: Fig8
case_images: The other feeding artery with a diameter of 3.4 mm was embolized with MVP-5Q delivered through a microcatheter 2.8 Fr (Renegade Hi-Flo; Boston ScientificMarlborough, MA, USA), but due to highly angulated feeding artery the MVP was displaced a little proximally and occluded the feeding artery a longer distance to the PAVM than intended (Fig. 8).