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Embolization of Hepatic Arteriovenous Malformations Using Radiolabeled and Nonradiolabeled Polyvinyl Alcohol Sponge in a Patient with Hereditary Hemorrhagic Telangiectasia: Case Report

Department of Radiology, Division of Nuclear Medicine, University of Utah School of Medicine, Salt Lake City, Utah

Correspondence: For reprints contact: Frederick L. Datz, MD, Nuclear Medicine Division, University of Utah Medical Center, 50 North Medical Dr., Salt Lake City, UT 84132.

ABSTRACT

Polyvinyl alcohol sponge (PVA) radiolabeled with ^99mTc-sulfur colloid was used to evaluate a large hepatic arteriovenous malformation (AVM) in a 71-yr-old white female prior to embolization. The patient had hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu) with severe left-to-right shunting through the hepatic AVM which resulted in high-output congestive heart failure. The patient also had severe pulmonary hypertension. Scintigraphic imaging of the embolized radiolabeled PVA particles allowed us to be certain that the particles did not flow through the liver and inadvertently embolize the lungs; with the patient's already poor pulmonary status, embolization could have been fatal.

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