Short- and mid-term outcome of transcatheter embolization of pulmonary sequestration in children: A single-center 22-years experience

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A pulmonary sequestration (PS) is a non-functioning bronchopulmonary tissue, not connected to the tracheobronchial tree and receiving arterial supply from the systemic circulation. Recently, transcatheter embolization of the feeding arteries has been reported as an effective and minimally invasive option but large series on outcomes in children are scarce. We aimed to evaluate the efficacy of endovascular embolization of PS and report short- and mid-term outcomes. Single-center retrospective clinical data review of all children referred to Cath lab at M3C-Necker-Enfants–Malades hospital for PS between Jan-1999 and May-2021. Demographic, clinical and procedural data were collected at baseline and at follow-up. Seventy-one patients were included. Median age and weight were 4.9 months (IQR: 2.1–26.6) and 4.2 kg (IQR: 3.9–12.1) respectively. Sixty-one (86%) patients had CHD, of which 47 had scimitar syndrome. Fifty-three (74.7%) patients had transcatheter embolization of PS. At baseline, 36 (68%) patients had PHT. One (1.4%) procedural death was reported. Two (2.8%) patients had PS surgical ligation that was too large for embolization. No patient needed PS surgical resection. Median follow-up was 36.4 months (IQR: 2.1–89.9) without residual shunt. Eight (11.3%) patients died with a median delay of 2.2 (IQR: 1.3–14.4) months after the procedure. Death was related to complex CHD. Thirty-one (86.1%) patients from those who had PHT became (PHT-Free) at last FU. Endovascular treatment of PS in children is safe and effective therapeutic option with very good short- and mid-term results leading to improvement in survival rates and to significant decrease in pulmonary hypertension.