Correct!
1. Catheter pulmonary angiography embolotherapy
The thoracic CT has already shown enlarged pulmonary arteries, indicating a target for embolotherapy, and the physiologic derangement necessitating treatment has been well documented. There is no adequate thoracic surgical approach for this patient’s condition, and the patient’s hypoxemia cannot be corrected with inspired oxygen. The patient does not have pulmonary hypertension and vasodilator therapy is not the correct choice.
The patient subsequently underwent catheter pulmonary angiography (Figure 5).
Figure 5. Catheter pulmonary angiography performed in the right (A) and left (B) lower lobes.
Catheter pulmonary angiography identified large, dilated, tortuous lower lobe pulmonary arteries bilaterally, but without a clear vascular nidus to suggest typical pulmonary arteriovenous malformation. The largest, abnormal lower lobe pulmonary arteries were embolized using coils (Figure 6), with good results.
Figure 6. Catheter pulmonary angiography with embolotherapy performed in the left lower lobe shows coil embolization of the enlarged, tortuous vessels, resulting in occlusion of these vessels.
Review the patient’s thoracic CT (Figure 2) again. Based in the information thus far, what is the patient’s diagnosis?