Transcatheter Embolization of Hepatic Arteriovenous Fistula in Osler-Weber-Rendu Disease — A Case Report

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Abstract
Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) is asso ciated with arteriovenous fistulas throughout the body that can cause hemody namic abnormalities. Owing to their size and extent, surgical repair is often not feasible. A patient referred for presumed valvular heart disease is described. On the basis of oximetry data at cardiac catheterization, a large intrahepatic arterio venous fistula was discovered by aortography. This finding and a history of recurrent epistaxis were consistent with Osler-Weber-Rendu disease. Owing to the size of the fistula, embolization of the right hepatic artery with Gianturco coils was chosen as treatment, with resultant symptomatic improvement and decreased arteriovenous shunting.