Endovascular embolization for Rasmussen's aneurysm with massive hemoptysis: 3 case reports and literature review

Abstract

This study aimed to explore the clinical features, the methods of pulmonary vascular interventional therapy, and the outcome of Rasmussen's Aneurysm (RA) with massive hemoptysis. A retrospective analysis of three cases of RA with massive hemoptysis was accomplished from the data collected through the literature review. A search through the PubMed database could retrieve information about 45 confirmed cases of pulmonary tuberculosis patients with massive hemoptysis attributed to RA. Three controls were also included in the study for unbiased statistical analysis of the data. All the 45 patients received chest CTA examination, 31 of whom (68.9%) showed RA by angiography. Lesions were mainly located in the upper lung of the patients, with an average diameter of 6.9 ± 3.9 mm. RA is classified into 4 types: 45 patients comprised 51.1% of type A (23 cases), 17.8% each respectively type B (8 cases) and type C (8 cases), and 4.4% of type D (2 cases). Two patients refused treatment whose prognoses were unknown, and another 2 died of asphyxia resulting from massive hemoptysis. A total of the forty-one patient received further treatment: 26 of them underwent pulmonary artery embolization, 7 received bronchial artery embolization, and the rest 8 received both bronchial artery and pulmonary embolization treatment. After treatment, one of the patients died of suffocation with massive hemoptysis during the surgical procedure, 38 recovered completely, and 2 showed recurrence of hemoptysis.Pulmonary vascular interventional therapy remains the preferred intervention for the remedy of RA accompanied by massive hemoptysis.