Bronchial artery embolization: Managing ruptured pulmonary artery venous malformation – A case report

A young 19 year old boy reported to the emergency with complaints of productive cough and mild haemoptysis over three days duration. Initial investigations were within normal limits. Symptoms suddenly aggravated and his condition deteriorated severely before further sophisticated investigations could be carried out. Urgent diagnostic bronchoscopy indicated it to be a case of spontaneously ruptured micro-vascular Pulmonary Arterio-Venous Malformation (PAVM) which was further confirmed on performing pulmonary angiography. Diameter of the feeding vessel was narrow causing difficulty in negotiating for coil embolotherapy. Occlusion of the bleeding artery was finally achieved by pushing in gel foam particles through the vessel. The boy recovered completely and remained asymptomatic one month after the intervention. PAVM is a relatively rare medical emergency where timely diagnosis and therapeutic embolization of the feeding vessel can be lifesaving as indicated in this case report.