CTICasesRecanalized Pulmonary AVM with Transpleural Collaterals
Imaging findings
CT in a patient with hereditary hemorrhagic telangiectasia (HHT) shows a recurrent right lower lobe arteriovenous malformation (AVM) that had been previously embolized with massive coils. The draining vein is patent, and there is extensive recruitment of transpleural systemic collaterals from the intercostal arteries.
Key takeaways
Recanalization of embolized pulmonary AVMs is a known complication. Over time, the lesion can recruit systemic arterial supply from transpleural (intercostal) pathways. This systemic recruitment makes repeat embolization difficult and often necessitates surgical lobectomy.
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