Fatal pulmonary embolism of polyvinyl alcohol particles following therapeutic embolisation of a peripheral arteriovenous malformation

Embolotherapy of arteriovenous malformations (AVM) is not without risk. A 28-year-old woman underwent transcatheter selective embolisation of an AVM in the cheek using polyvinyl alcohol (PVA) microparticles. She became hypoxic and hypotensive post procedure, and had repeated cardiorespiratory arrest...

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Bibliographic Details
Published in:BMJ case reports 2009, Vol.2009 (jul14 1), p.bcr0220091635-bcr0220091635
Main Authors: Wijeyaratne, Serosha Mandika, Ubayasiri, Ranjuka Arushana, Weerasinghe, Charitha
Format: Article
Language:English
Subjects:
Asia
Atoms & subatomic particles
Catheters
Deformities
Embolisms
Female
Indian Sub-Continent
Medical imaging
Particle size
Pulmonary arteries
Pulmonary hypertension
Sulfur
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
Veins & arteries
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Summary:Embolotherapy of arteriovenous malformations (AVM) is not without risk. A 28-year-old woman underwent transcatheter selective embolisation of an AVM in the cheek using polyvinyl alcohol (PVA) microparticles. She became hypoxic and hypotensive post procedure, and had repeated cardiorespiratory arrests despite aggressive support. Resistant hypoxia with gross right heart dilatation on echocardiography suggested extensive pulmonary embolism. She died 24 h later. A postmortem confirmed widespread thrombosis and PVA particles in the pulmonary microvasculature identical to that in the treated AVM. This is the first reported death from PVA particle pulmonary embolism following therapeutic embolisation of a peripheral AVM.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.02.2009.1635