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Successful Endovascular Treatment of a Ruptured Giant Lumbar Arteriovenous Malformation

Vascular Specialist International 2020년 36권 1호 p.33 ~ 37
Meuli Lorenz, Galanis Nektarios, Dick Florian,
소속 상세정보
 ( Meuli Lorenz ) - St. Gallen Cantonal Hospital Department of Vascular Surgery
 ( Galanis Nektarios ) - St. Gallen Cantonal Hospital Department of Vascular Surgery
 ( Dick Florian ) - St. Gallen Cantonal Hospital Department of Vascular Surgery

Abstract


Arteriovenous malformations (AVMs) are rare congenital vascular anomalies where rupture can be fatal. This report describes a case of a 69-year-old woman who presented with sudden severe lower back pain radiating to her left buttock and thigh and an inability to move her left leg. Computed tomography angiography (CTA) showed an extensive ruptured retroperitoneal AVM on the left paravertebral side with active bleeding and a large hematoma. Cardiopulmonary resuscitation with considerable blood transfusion was required. The AVM was effectively treated with coil embolization of the feeding lumbar arteries. Shortly after the intervention, the patient developed abdominal compartment syndrome. Urgent laparotomy with evacuation of the retroperitoneal hematoma was required. The patient was discharged 16 days after admission in a good physical condition and has been free of symptoms for more than a year after intervention. However, follow-up CTA showed residual contrast enhancement in the AVM and further surveillance is required.

키워드

Vascular malformations; Arteriovenous malformations; Lumbar artery; Ruptured aneurysm; Therapeutic embolization

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