In hereditary hemorrhagic telangiectasia (HHT), pulmonary arteriovenous malformations(PAVM)is frequent complications. PAVM causes paradoxical embolism, brain abscess and hypoxemia. Transcatheter coil embolization is performed as a treatment. We report four patients case with diffuse PAVM.
[Case 1] A 16-year-old male, a chest abnormal shadow was pointed out at a medical examination. The arterial blood gas analysis PaO2 at the first visit was 49 Torr, and the right-to-left shunt rate was 26.9 %. [Case 2] A 14-year-old male, brother of case 1. At the first visit PaO2 64.1 Torr, shunt rate was 25.7 %. [Case 3] A 37-year-old female, had nasal bleeding from childhood. At the first visit PaO2 54 Torr, shunt rate was 25.2 %. [Case 4] A 27-year-old male, diagnosed as HHT at early childhood. At the first visit PaO2 62 Torr, shunt rate was 26.2%. Coil embolization was performed for all cases. But many small diffuse lesions which are not indicated as therapeutic indications have not been treated, improvement of oxygenation was poor. The purpose of embolization is to prevent paradoxical embolism, brain abscess and improve hypoxemia. In patients with diffuse PAVM, improvement of hypoxemia is poor and it is a future treatment issue.