Figure 2

A 62 year-old woman with three PAVMs (Case 6). A. The selective angiogram shows the PAVM in the posterior segment. B. The distal feeding artery was embolized with three 6-4 mm hydrogel microcoils and four additional 3 mm bare platinum microcoils. C. Selective angiogram of the small PAVM in the superior segment shows the tortuosity of the distal feeding artery. D. Because of microcatheter instability, six 4-3 mm 0.014-inch bare detachable microcoils alone were deployed. Post embolization angiogram shows the feeding artery occlusion. E. After two months, the follow-up pulmonary arteriogram was obtained in the second session to treat the PAVM in the right lung (not shown). The PAVM in the posterior segment treated by hydrogel microcoils remained occluded, whereas the smaller PAVM in the superior segment treated by bare microcoils alone shows recanalization (arrow). F. Selective angiogram reveals the recanalization through the coil interstices. Four additional 3 mm bare microcoils were packed proximally to achieve complete occlusion (not shown). G. The baseline non-contrast CT image shows the venous sac (arrow) and the draining vein of the PAVM in the posterior segment (arrowhead). H. The eleven-month follow-up CT shows shrinkage of the venous sac (arrow) and normalization of the draining vein size (arrowhead).