On arrival, her blood pressure was 90/50, and her oxygen saturation was 94% on 60% oxygen. She was in moderate distress with decreased breath sounds on the right. The patient was taken emergently for a pulmonary angiogram that demonstrated the PAVM in the right lower lobe. Next, the right lower lobe artery to the PAVM was selectively entered and treated by transcatheter embolization (TCE) (Figs 1B, 1C). Subsequently a chest tube was inserted and 1,200 mL of blood removed. The residual hemothorax was managed with small amounts of tissue plasminogen activator placed through a separate pigtail catheter. On hospital day 8, both catheters were removed without reaccumulation, and the patient was discharged home.