Korean J Anesthesiol.  2008 Jun;54(6):673-676. 10.4097/kjae.2008.54.6.673.

Atrial Fibrillation during Ethanol Sclerotherapy in a Patient with Lower Limb Arteriovenous Malformation: A case report

• Chung IS
• Choi SJ
• Lee SM
• Gwak MS
• Yoon JS

• KMID: 1763525
• DOI: http://doi.org/10.4097/kjae.2008.54.6.673

Abstract

Alcohol embolization or sclerotherapy has been commonly used for a treatment of arteriovenous malformation (AVM). Alcohol sclerotherapy frequently produces minor local complications but may rarely produce catastrophic cardiopulmonary complications. In this case, general anesthesia was induced and the pulmonary artery pressure was monitored. After absolute alcohol (99.6% ethanol) injection, the systolic pulmonary artery pressure was increased, the systemic blood pressure was decreased and the EKG rhythm revealed supraventricular tachycardia and atrial fibrillation. Nitroglycerine, dobutamine, and milrinone infusions were started for the treatment of pulmonary hypertension. The EKG was restored to normal sinus rhythm two hours after judicious fluid administration and other vital signs were also recovered. The anesthesiologists must be aware of potentially serious cardiopulmonary complications possible with alcohol sclerotherapy and be prepared to manage severe cardiovascular compromise.

Keyword

arteriovenous malformation; atrial fibrillation; ethanol sclerotherapy; pulmonary hypertension

MeSH Terms

Anesthesia, General
Arteriovenous Malformations
Atrial Fibrillation
Blood Pressure
Dobutamine
Electrocardiography
Ethanol
Humans
Hypertension, Pulmonary
Lower Extremity
Milrinone
Nitroglycerin
Pulmonary Artery
Sclerotherapy
Tachycardia, Supraventricular
Vital Signs
Dobutamine
Ethanol
Milrinone
Nitroglycerin