A boy with a complex Galen’ vein arterovenous malformation was developing multiple endovascular embolisations every 3 months from birth. A treatment was scheduled at 15 months of age. During the angiographic procedure, some of the colloidal glue was seen to suddenly migrate into the lung vascular bed, and the embolisation was therefore stopped. No changes in respiratory pattern, arterial oxygen saturation or heart rate were observed.

The infant was admitted to the paediatric intensive care unit, and emergency chest radiography was performed; a typical lung micro-embolism feature was observed (fig 1). Close monitoring of vital functions was performed, and no changes were noticed. Echocardiography showed a slightly increased pulmonary artery pressure (30 mm Hg), but the boy required no supplemental oxygen. A chest radiograph after 3 days showed no change in appearance, and his clinical condition remained good throughout. The infant was successfully discharged from hospital after a week, and the 1-month follow-up examination was completely normal.

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Figure 1 Diffuse lung micro-embolism, following an angiographic procedure to embolise an arterovenous Galen’s vein malformation.

Accidental embolism following an angiographic procedure has been previously suspected in only one report; it was suspected because of the patient’s rapidly worsening vital functions.1 The condition of our patient was never critical, but we were able to demonstrate passage of glue into the vascular bed of the lung; this is the first image available in the literature of colloidal glue diffuse lung embolism.