Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report
We report the first successful coil embolization using a gadolinium contrast agent (GCA) of 3 pulmonary arteriovenous malformations (PAVMs) in a patient with severe iodine allergy. The patient was a female in her 40s with hereditary hemorrhagic telangiectasia. The 3 PAVMs had sacs with diameters of...
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Elsevier
2025-06-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043325002079 |
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| author | Atsufumi Kamisako, MD, PhD Akira Ikoma, MD, PhD Tetsuo Sonomura, MD, PhD Takahiro Naka, MD Yuichi Miyake, MD Ryosuke Mimura, MD Kurumi Tamai, MD Kazuhiro Murotani, PhD Hiroki Minamiguchi, MD, PhD |
| author_facet | Atsufumi Kamisako, MD, PhD Akira Ikoma, MD, PhD Tetsuo Sonomura, MD, PhD Takahiro Naka, MD Yuichi Miyake, MD Ryosuke Mimura, MD Kurumi Tamai, MD Kazuhiro Murotani, PhD Hiroki Minamiguchi, MD, PhD |
| author_sort | Atsufumi Kamisako, MD, PhD |
| collection | DOAJ |
| description | We report the first successful coil embolization using a gadolinium contrast agent (GCA) of 3 pulmonary arteriovenous malformations (PAVMs) in a patient with severe iodine allergy. The patient was a female in her 40s with hereditary hemorrhagic telangiectasia. The 3 PAVMs had sacs with diameters of up to 20 mm and pulmonary feeding arteries with diameters of up to 5 mm. The PAVMs were located in segment (S) 8 and S9 of the right lung, and S8 of the left lung. Embolization was planned after administration of steroids and antihistamines. However, the procedure was stopped because preoperative pulmonary arteriography using an iodine contrast agent caused pharyngeal itching, coughing, and decreased percutaneous oxygen saturation. Because surgical resection is highly invasive, embolization using a GCA was selected as an alternative treatment strategy. After obtaining approval from our hospital's ethical review board, embolization with a GCA was planned. Embolization was performed in 3 separate sessions. The catheter's position was monitored and adjusted under angiography with manual injection of a GCA and low-dose computed tomography (CT) using an interventional radiology-CT system. The GCA was visible on angiography and coil embolization of the PAVM sacs and feeding arteries was performed. A small amount of GCA was used (7‒9 mL). The patient experienced no allergic reactions during the procedure. Although there are many reports of endovascular treatment using GCA for dialysis shunt stenosis and cerebrovascular disease in patients with iodine allergy, this is the first report describing the use of GCA during PAVM embolization. |
| format | Article |
| id | doaj-art-206f79c9210f45cf8b6cfab89f85bf64 |
| institution | OA Journals |
| issn | 1930-0433 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj-art-206f79c9210f45cf8b6cfab89f85bf642025-08-20T02:16:55ZengElsevierRadiology Case Reports1930-04332025-06-012062974297910.1016/j.radcr.2025.02.106Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case reportAtsufumi Kamisako, MD, PhD0Akira Ikoma, MD, PhD1Tetsuo Sonomura, MD, PhD2Takahiro Naka, MD3Yuichi Miyake, MD4Ryosuke Mimura, MD5Kurumi Tamai, MD6Kazuhiro Murotani, PhD7Hiroki Minamiguchi, MD, PhD8Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, Japan; Corresponding author.Department of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Central Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanDepartment of Radiology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8509, JapanWe report the first successful coil embolization using a gadolinium contrast agent (GCA) of 3 pulmonary arteriovenous malformations (PAVMs) in a patient with severe iodine allergy. The patient was a female in her 40s with hereditary hemorrhagic telangiectasia. The 3 PAVMs had sacs with diameters of up to 20 mm and pulmonary feeding arteries with diameters of up to 5 mm. The PAVMs were located in segment (S) 8 and S9 of the right lung, and S8 of the left lung. Embolization was planned after administration of steroids and antihistamines. However, the procedure was stopped because preoperative pulmonary arteriography using an iodine contrast agent caused pharyngeal itching, coughing, and decreased percutaneous oxygen saturation. Because surgical resection is highly invasive, embolization using a GCA was selected as an alternative treatment strategy. After obtaining approval from our hospital's ethical review board, embolization with a GCA was planned. Embolization was performed in 3 separate sessions. The catheter's position was monitored and adjusted under angiography with manual injection of a GCA and low-dose computed tomography (CT) using an interventional radiology-CT system. The GCA was visible on angiography and coil embolization of the PAVM sacs and feeding arteries was performed. A small amount of GCA was used (7‒9 mL). The patient experienced no allergic reactions during the procedure. Although there are many reports of endovascular treatment using GCA for dialysis shunt stenosis and cerebrovascular disease in patients with iodine allergy, this is the first report describing the use of GCA during PAVM embolization.http://www.sciencedirect.com/science/article/pii/S1930043325002079Coil embolizationGadolinium contrast agentIodine allergyLow-dose computed tomographyPulmonary arteriovenous malformation |
| spellingShingle | Atsufumi Kamisako, MD, PhD Akira Ikoma, MD, PhD Tetsuo Sonomura, MD, PhD Takahiro Naka, MD Yuichi Miyake, MD Ryosuke Mimura, MD Kurumi Tamai, MD Kazuhiro Murotani, PhD Hiroki Minamiguchi, MD, PhD Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report Radiology Case Reports Coil embolization Gadolinium contrast agent Iodine allergy Low-dose computed tomography Pulmonary arteriovenous malformation |
| title | Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report |
| title_full | Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report |
| title_fullStr | Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report |
| title_full_unstemmed | Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report |
| title_short | Successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy: A case report |
| title_sort | successful coil embolization of 3 pulmonary arteriovenous malformations using a gadolinium contrast agent in a patient with severe iodine allergy a case report |
| topic | Coil embolization Gadolinium contrast agent Iodine allergy Low-dose computed tomography Pulmonary arteriovenous malformation |
| url | http://www.sciencedirect.com/science/article/pii/S1930043325002079 |
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