AmplatzerⓇ 혈관폐색장치를 이용한 거대 폐동정맥기형 색전술 1예
Transcatheter Embolotherapy of Giant Pulmonary Arteriovenous Malformation Using AmplatzerⓇ Vascular Plug
이승화 (고려대학교)
신철 (고려대학교)
김제형 (고려대학교)
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초록
폐동정맥기형은 드문 폐혈관 질환으로 출혈, 뇌농양,기이 색전증(paradoxical embolism)에 의한 여러 신경학적 합병증의 발생 위험을 증가시켜 치료를 요한다. 과거에는 수술적으로 제거했으나, 최근에는 주로 코일 및 풍선등의 다양한 색전물질을 이용한 경피적 색전술을 시행하여 치료하는 추세이다. 거대 폐동정맥기형의 경우에는 색전술 시행 과정에서 코일이 전신 순환으로 빠져 나가 장치색전증 등의 합병증을 일으킬 위험이 높다. 저자들은 호흡곤란을 주소로 내원한 81세 남자 환자에게서, 지속되는저산소혈증의 원인으로 거대 폐동정맥기형을 진단하고,AmplatzerⓇ 혈관폐색장치를 이용한 경피적 색전술로 치료한 1예를 경험하였기에, 문헌 고찰과 함께 보고하는 바이다.
- keywords
- Arteriovenous malformations, Pulmonary disease, Therapeutic embolization
Abstract
Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary vascular anomaly due to an abnormal communication between the pulmonary artery and vein. The most common presenting symptom is a dyspnea on exertion related to this right-to-left shunt. If left untreated, PAVM has been known to result in serious complications. Incomplete pulmonary capillary network can be the cause of cerebral abscesses and other noninfectious neurological complications, such as stroke and transient ischemic attacks due to paradoxic embolism Transcatheter embolotherapy, using coils or balloons, has replaced surgical resection as the treatment of choice for PAVM. However, the risk of device embolization has limited the use of coil embolotherapy, while the size of PAVM is huge. Recently, AmplatzerⓇ Vascular Plug has been proposed as an alternative endovascular occlusiondevice for arteriovenous malformation. We report a case of 81-year-old male patient with a giant PAVM, which was successfully treated by transcatheter embolotherapy using the AmplatzerⓇ Vascular Plug.
- keywords
- Arteriovenous malformations, Pulmonary disease, Therapeutic embolization
참고문헌
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