Clinical significance of supplemental transcatheter arterial embolization of thyrocervical trunk in the interventional procedure for peripheral disease

Abstract

Objective To describe the manifestations of thyrocervical trunk blood supply in hemoptysis or tumor and to evaluate the safety and efficacy of transcatheter arterial embolization (TAE) of the thyrocervical trunk. Methods During the past 2 years, 13 patients with hemoptysis and malignant tumor underwent BAE. Mean patient age was 44.5 years (range, 25—69 years). Supplemental TAE using PVA particles, gelatin sponge particles and microcoils was undertaken in the thyrocervical trunk supplying cases. The imaging findings of the thyrocervical trunk angiography, the predictive factors, the technique and clinical significance, including safety of the thyrocervical trunk embolization, were evaluated. Results Selective arteriogram demonstrated enlargement of the thyrocervical trunk, with numerous branches and neovsaculature in all 13 cases, including contrast material extravasation in 4, tumor staining in 5, and non-specific staining in 4 cases. Technical success of thyrocervical trunk embolization was achieved in all 13cases. Embolization of other nonbronchial systemic arteries (the internal thoracic artery in 9、intercostal artery in 8 and inferior phrenic artery in 3 cases) and bronchial artery in 7 cases were performed at the same session. All bleedings ceased immediately after supplemental thyrocervical trunk embolization. Follow-up ranged from 2 months to 2 years, no recurrent bleeding in 11 patients. The patients with mediastinal mass received resection after embolization. Conclusions Thyrocervical trunk may be a supplemental artery for hemoptysis and mediastinal mass, resulting in clinical failure of BAE and supplemental TAE of thyrocervical trunk is a safe and effective adjunct to BAE in the management. Key words: Hemoptysis; Arteries, bronchial; thyrocervical trunk; Angiography; Embolization, therapeutic