A pregnant woman presented with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome) and a single pulmonary arteriovenous malformation (AVM) that had been embolized 5 years previously. Partly due to pregnancy, recanalization of the aneurysm occurred with subsequent hemoptysis. Despite successful therapeutic reembolization of the afferent pulmonary artery, hemoptysis recurred 5 days later. At this time, recanalization of the pulmonary artery was not demonstrated by pulmonary angiography, but a systemic angiogram revealed a bronchial arterial supply to the pulmonary AVM. A systemic supply should always be sought in cases of recurrent hemoptysis after technically successful embolization of the feeding pulmonary artery.
Wispelaere, J. F., Trigaux, J.-P., Weynants, P., Delos, M., & Coene, B. D. (1996). Systemic supply to a pulmonary arteriovenous malformation: potential explanation for recurrence. Cardiovascular and Interventional Radiology, 19(4), 285-287. https://doi.org/10.1007/BF02577652 (Original work published 1996)