PT  - JOURNAL ARTICLE
AU  - Grady, Kimberley
AU  - Gowda, Srinath
AU  - Kingah, Pascal
AU  - Soubani, Ayman O
TI  - Coil Embolization of Pulmonary Arteries as a Palliative Treatment of Diffuse Type I Hepatopulmonary Syndrome
AID  - 10.4187/respcare.03198
DP  - 2014 Sep 02
TA  - Respiratory Care
PG  - respcare.03198
4099  - http://rc.rcjournal.com/content/early/2014/09/02/respcare.03198.short
4100  - http://rc.rcjournal.com/content/early/2014/09/02/respcare.03198.full
AB  - Hepatopulmonary syndrome is a serious complication of liver disease. Type I hepatopulmonary syndrome is associated with diffuse dilatation of the pulmonary vasculature, leading to severe hypoxemia. Liver transplantation is the treatment of choice for this condition. There are limited options for those who are not candidates for liver transplantation. We present the case of a patient who presented with severe hypoxemia requiring FIO2 of 0.95 with PaO2 of 59 mm Hg. Workup revealed 33% intrapulmonary right-to-left shunt. A pulmonary angiogram showed diffuse dilatation of the pulmonary arteries, especially in the lower lobes. The patient was diagnosed with type I hepatopulmonary syndrome. He was not a candidate for liver transplantation. The patient underwent sequential coil embolizations of the lower lobe pulmonary arteries. He was discharged home on 2 L of supplemental oxygen. This case demonstrates that coil embolization of dilated pulmonary arteries is a potential palliative treatment for patients with diffuse type I hepatopulmonary syndrome.