Snapshot quiz 20/8

Published: 09/16/2020

Authors: Rohith G, Dutta S, Rajkumar N and Tajudeen M

Pelvic arteriovenous malformation (AVM). CT angiography (a, b) showed an AVM arising from bilateral internal iliac arteries. Multiple sessions of endovascular coil embolization (c) of the feeder vessels were undertaken over 2 years, but it kept recurring. External beam radiotherapy (20 Gy; 5 doses in 7 days) to the AVM was tried, but was unsuccessful. Surgical ligation of the feeders was done (d) but the patient died shortly after surgery from severe transfusion-related acute lung injury. Pelvic AVMs are rare and pose a challenge to treat owing to their location and extensive feeding vessels.