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Background <p>A chronic pulmonary arteriovenous fistula (PAVF) post penetrating thoracic injury is rare; this case demonstrates the presentation, diagnostic implications and a successful endovascular approach to close it.</p> Case presentation <p>We report the case of a rare pulmonary arteriovenous fistula in a 50-year-old man secondary to historic thoracic shrapnel injury. He had a positive bubble study on echocardiography; CT pulmonary angiogram identified a pulmonary arteriovenous fistula. He underwent successful repair with an endovascular approach.</p> Conclusion <p>PAVF can result from penetrating chest trauma. An intra-pulmonary shunt should be suspected in the setting of hypoxaemia refractory to oxygen therapy and when there is no evidence of an intra-cardiac shunt. Endovascular intervention can facilitate definitive treatment by employing a plug-in-stent technique.</p>

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Pulmonary arteriovenous fistula secondary to historic thoracic shrapnel injury: presenting features and interventional approach

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月14日

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  • Kate Chiswell,
  • Ahmed Al-Hindawi,
  • Richard Dunn,
  • Richard Waugh,
  • Rachael Cordina

摘要

Background

A chronic pulmonary arteriovenous fistula (PAVF) post penetrating thoracic injury is rare; this case demonstrates the presentation, diagnostic implications and a successful endovascular approach to close it.

Case presentation

We report the case of a rare pulmonary arteriovenous fistula in a 50-year-old man secondary to historic thoracic shrapnel injury. He had a positive bubble study on echocardiography; CT pulmonary angiogram identified a pulmonary arteriovenous fistula. He underwent successful repair with an endovascular approach.

Conclusion

PAVF can result from penetrating chest trauma. An intra-pulmonary shunt should be suspected in the setting of hypoxaemia refractory to oxygen therapy and when there is no evidence of an intra-cardiac shunt. Endovascular intervention can facilitate definitive treatment by employing a plug-in-stent technique.