Abstract
BackgroundPulmonary pseudoaneurysm (PPA) is a potentially lethal complication of lung resection with a high risk of recurrence after endovascular coiling.Case presentationWe report a case in which recurrent hemoptysis due to PPA after left lower lobe sleeve resection was treated by endovascular embolization of the left main pulmonary artery as a salvage treatment. The first hemoptysis was managed by endovascular coil embolization with extracorporeal membrane oxygenation, but refractory hemorrhage occurred 3 months later due to penetration of the endovascular coil into the bronchial anastomosis site. Because left completion pneumonectomy was considered too high risk, the left main pulmonary artery was palliatively embolized using an Amplatzer vascular plug (St. Jude Medical, MN, USA) to totally disrupt the left pulmonary arterial flow.ConclusionsTotal embolization of the left main pulmonary artery for repeated PPA rupture may be useful as a palliative treatment in patients unable to tolerate pneumonectomy.
Highlights
Pulmonary pseudoaneurysm (PPA) is a potentially lethal complication of lung resection with a high risk of recurrence after endovascular coiling.Case presentation: We report a case in which recurrent hemoptysis due to PPA after left lower lobe sleeve resection was treated by endovascular embolization of the left main pulmonary artery as a salvage treatment
Total embolization of the left main pulmonary artery for repeated PPA rupture may be useful as a palliative treatment in patients unable to tolerate pneumonectomy
We report a case in which recurrent hemoptysis in a patient with a PPA following left lower lobe sleeve resection after induction chemoradiation therapy (ICRT) was treated endovascularly as an alternative to pneumonectomy
Summary
Bronchovascular fistula occurs in 1–3% of patients during the first 4 weeks after a bronchoplastic procedure [1, 2]. Hemoptysis due to a bronchial fistula with a pulmonary pseudoaneurysm (PPA) is an extremely rare condition that requires emergency lifesaving treatment [3]. We report a case in which recurrent hemoptysis in a patient with a PPA following left lower lobe sleeve resection after induction chemoradiation therapy (ICRT) was treated endovascularly as an alternative to pneumonectomy. Case presentation The patient was a 60-year-old man with cT2bN2M0 (Sq, 45 mm, LN#4L) (Fig. 1A). After ICRT (carboplatin/ paclitaxel + 40 Gy), he developed moderate radiation pneumonitis and ipsilateral pulmonary artery emboli from deep venous thrombosis, which required medical treatment with oral steroids and a novel oral anticoagulant drug (Fig. 1C).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
