SYSTEMIC SUPPLY TO A PULMONARY ARTERIOVENOUS MALFORMATION - POTENTIALEXPLANATION FOR RECURRENCE

A pregnant woman presented with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) and a single pulmonary arteriovenous malf ormation (AVM) that had been embolized 5 years previously, Partly due to pregnancy, recanalization of the aneurysm occurred with subsequent hemoptysis. Despite successful therapeutic reembolization of the affer ent pulmonary artery, hemoptysis recurred 5 days later. At this time, recanalization of the pulmonary artery was not demonstrated by pulmona ry angiography, but a systemic angiogram revealed a bronchial arterial supply to the pulmonary AVM. A systemic supply should always be sough t in cases of recurrent hemoptysis after technically successful emboli zation of the feeding pulmonary artery.