Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Hereditary Hemorrhagic Telangiectasia with Pulmonary Arteriovenous Malformations and Embolic Strokes Treated Successfully with Video-assisted Thoracoscopic Resection
Shintaro AkiyamaShigeo HanadaHironori UrugaHisashi TakayaAtsushi MiyamotoNasa MorokawaAtsuko KurosakiTakeshi FujiiTadasu KohnoKazuma Kishi
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JOURNAL OPEN ACCESS

2013 Volume 52 Issue 10 Pages 1091-1094

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Abstract

A 67-year-old hypoxic woman was admitted following two episodes of cerebral infarction. Based on the clinical presentation and radiological findings, a diagnosis of hereditary hemorrhagic telangiectasia was made and the cerebral ischemic complications were considered to have been caused by paradoxical embolizations related to pulmonary arteriovenous malformations (PAVMs). We performed video-assisted thoracoscopic surgery (VATS) and identified turbulent thrombi in one of the PAVMs that were capable of circulating systemically and inducing embolic strokes. The condition of the patient improved immediately following VATS. This case suggests that VATS may be a preferred therapeutic option in the treatment of patients with PAVM accompanying recurrent episodes of life-threatening complications such as strokes.

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© 2013 by The Japanese Society of Internal Medicine
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