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Korean J Anesthesiol > Volume 54(6); 2008 > Article
Korean Journal of Anesthesiology 2008;54(6):673-676.
DOI: https://doi.org/10.4097/kjae.2008.54.6.673   
Atrial Fibrillation during Ethanol Sclerotherapy in a Patient with Lower Limb Arteriovenous Malformation: A case report.
In Sun Chung, Soo Joo Choi, Sang Min Lee, Mi Sook Gwak, Jin Sun Yoon
Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. jinsun.yoon@samsung.com
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.
Key Words: arteriovenous malformation; atrial fibrillation; ethanol sclerotherapy; pulmonary hypertension
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