Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

2019 ◽  
Vol 53 (6) ◽  
pp. 492-496
Author(s):  
Yuan Li ◽  
Guang-Chao Gu ◽  
Bao Liu ◽  
Jiang Shao ◽  
Yu Chen ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Artery Aneurysm ◽  
Transcatheter Embolization ◽  
Life Threatening ◽  
Nontarget Embolization ◽  
Feeding Vessels ◽  
The Right

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient’s cough resolved at 6-month follow-up.

scholarly journals Endobronchial Watanabe spigot complementing prophylactic balloon blocker in the management of post-transbronchial cryobiopsy bleeding

2021 ◽  
pp. 201010582110194
Author(s):  
Larry Ellee Nyanti ◽  
Sze Shyang Kho ◽  
Swee Kim Chan ◽  
Chan Sin Chai ◽  
Siew Teck Tie
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Bronchial Artery ◽  
Middle Lobe ◽  
Definitive Method ◽  
Life Threatening ◽  
Right Middle Lobe ◽  
Bronchial Artery Embolisation ◽  
Definitive Management

Transbronchial cryobiopsy (TBCB) is performed to aid diagnosis of interstitial lung disease, of which bleeding is a potentially life-threatening complication. Post-TBCB management involves temporary balloon blockade, bronchial artery embolisation (BAE) or surgery. Bronchial occlusion by endobronchial Watanabe spigot (EWS) as the definitive method of bleeding control post TBCB has not been described. A 56-year-old male underwent TBCB to aid diagnosis of interstitial lung disease. TBCB had been performed at RB4 (lateral segment of right middle lobe) with a prophylactic balloon blocker. However, prolonged bleeding was observed upon deflation of the balloon blocker. Haemostasis was secured with successful deployment of EWS into RB4, with no evidence of rebleeding in surveillance bronchoscopy and chest radiographs. EWS was kept in situ for four days and subsequently removed. The patient was discharged with good functional status. This case demonstrates that EWS placement may be considered for definitive management of low-volume post-TBCB bleeding, especially when BAE and surgical intervention are not possible.

scholarly journals Fast-Onset Diffuse Interstitial Lung Disease in Anti-MDA5 Antibodies-Associated Amyopathic Dermatomyositis

2021 ◽  
Vol 11 (2) ◽  
pp. 235-240
Author(s):  
Houari Aissaoui ◽  
Kinan Drak Alsibai ◽  
Naji Khayath
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Distress Syndrome ◽  
Early Stage ◽  
Immunosuppressive Treatment ◽  
Amyopathic Dermatomyositis ◽  
Pulmonary Manifestations ◽  
Life Threatening ◽  
Adequate Management ◽  
Chest Ct Scan

Anti-MDA5 antibodies-associated amyopathic dermatomyositisis a rare autoimmune disease that involve polyarthritis, cutaneous and pulmonary manifestations. The development of rapidly progressing interstitial lung disease is a life-threatening complication. We report the case of a 45-year-old woman without medical history, who was addressed to the Pulmonary Department for a polyarthritis with dry cough and hypoxemic dyspnea. Initially there was neither cutaneous manifestation nor interstitial lung disease on chest CT scan. After a few days, the patient developed fatal acute respiratory failure with diffuse ground glass opacities. Identification of anti-MDA5 antibodies allowed establishing diagnosis, despite the fact that the first immunological assessment was negative. Corticosteroid bolus of 1 g for three days and immunosuppressive treatment by cyclophosphamide was only initiated at the acute respiratory distress syndrome stage. Given the rapidly unfavorable prognosis of this entity of amyopathic dermatomyositis, the testing for anti-MDA5 antibodies should be recommended in case of progressive pulmonary symptoms associated with joint signs in order to identify this disease at an early stage and to begin rapid and adequate management.

scholarly journals Surgery Combined With Embolization in the Treatment of Plexiform Neurofibroma: A Case Report and Literature Review

2021 ◽  
Vol 6 (4) ◽  
pp. 01-04
Author(s):  
Reinaldo Filho
Keyword(s):  
Plexiform Neurofibroma ◽  
Arterial Embolization ◽  
Neurofibromatosis Type ◽  
Self Esteem ◽  
Life Threatening ◽  
Feeding Vessels ◽  
The Right ◽  
Polyvinyl Alcohol Particles

Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem genodermatosis resulting from a mutation on chromosome 17q11.2, characterized by diverse clinical expression with involvement of the skin, nervous system, bones, eyes and other systems. Neurofibromas are tumors located along nerve bundles; when they become large, they are called plexiform neurofibromas. Complications of neurofibromas are rare, but include malignant transformation and potentially life-threatening hemorrhages. A comprehensive perioperative management, including arterial embolization of feeding vessels, is required in order to perform a safe surgical procedure and to reduce potential surgical complications. We report a case of a large plexiform neurofibroma on the right flank, treated in a two-stage approach: first, embolization with polyvinyl alcohol particles of the inferior epigastric, lumbar and superior gluteal arteries on the right and, second, 24 hours after embolization, exeresis of the lesion, which weighed 2.5 kg. Two years after surgery, the patient was asymptomatic, without tumor recurrence and with an important improvement in self-esteem and quality of life.

scholarly journals A case of Multiple Unilateral Pulmonary arteriovenous Malformation Relapse: Efficacy of embolization treatment

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Rossella Masiello ◽  
Carlo Iadevaia ◽  
Edoardo Grella ◽  
Carmelindo Tranfa ◽  
Francesco Cerqua ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Clinical Manifestations ◽  
Transcatheter Embolization ◽  
Functional Improvement ◽  
Embolization Treatment ◽  
Angio Ct ◽  
Vascular Alteration ◽  
Arteries And Veins ◽  
Ischemic Events

Abstract Pulmonary arteriovenous Malformations (PAVMs) are a rare vascular alteration characterized by abnormal communications between the pulmonary arteries and veins resulting in an extracardiac right-to-left (R-L) shunt. The majority of PAVMs are associated with an autosomal dominant vascular disorder also known as Osler-Weber- Rendu Syndrome. PAVMs appearance can be both single and multiple. Clinical manifestations include hypoxemia, dyspnea cyanosis, hemoptysis and cerebrovascular ischemic events or abscesses. We report a case of an 18 year old female with severe respiratory failure caused by a relapse of multiple unilateral pulmonary arterovenous fistula. Symptoms at admission include dyspnea, cyanosis and clubbing. The patient underwent pulmonary angio-TC scan, brain CT and echocardiography. The thoracic angio-CT scan showed the presence of PAVMs of RUL and RLL; a marked increase of right bronchial artery caliber and its branches with an aneurismatic dilatation was also observed. The patient underwent percutaneous transcatheter embolization using Amplatzer Vascular Plug IV; a relevant clinical and functional improvement was subsequently recorded. Embolization is effective in the treatment of relapsing PAVMS.

scholarly journals Bi-lung transplantation in anti-synthetase syndrome with life-threatening interstitial lung disease

Rheumatology ◽  
2018 ◽  
Vol 57 (9) ◽  
pp. 1688-1689 ◽  
Author(s):  
Marion Delplanque ◽  
Marc Gatfosse ◽  
Hafid Ait-Oufella ◽  
Olaf Mercier ◽  
Laurent Savale ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Transplantation ◽  
Lung Disease ◽  
Life Threatening

Transcatheter embolization of congenital coronary arterial fistulas in adults

1999 ◽  
Vol 9 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Antônio M. Kambara ◽  
Carlos A. C. Pedra ◽  
C,sar A. Esteves ◽  
Manoel N. Cano ◽  
Sérgio L. N. Braga ◽  
...  
Keyword(s):  
Bronchial Artery ◽  
Transcatheter Embolization ◽  
Pulmonary Trunk ◽  
Circumflex Artery ◽  
Catheterization Laboratory ◽  
Transcatheter Occlusion ◽  
Acceptable Alternative ◽  
The Right ◽  
Guiding Catheter

AbstractIn this report, we describe our experience with transcatheter occlusion of congenital coronary arterial fistulas in adults. From November 1992 to November 1996, 5 symptomatic patients, aged from 47 to 70 years, underwent transcatheter occlusion of fistulas using a retrograde arterial approach. All had chest pain or dyspnea on exertion. Detachable balloons were used in 4 patients, and Gianturco coils in 1. Detachable balloons were implanted through a Debrun system, while the coils were implanted through a 5 French right coronary Judkins catheter. Both were passed through an 8 French guiding catheter (Amplatz II). Each patient had a single fistula. The fistulas originated from the right coronary artery in 3 patients, and from the circumflex artery in 2. They drained into the pulmonary trunk in 3 patients, into the right atrium in 1, andinto a bronchial artery in the other. All fistulas were occluded completely in the catheterization laboratory, and the procedures were uncomplicated. At follow up, 3 patients underwent coronary angiography, and there was no evidence of recanalization. Transcatheter embolization in adults of single congenital coronary fistulas with detachable balloons and coils is safe and effective and can be regarded as an acceptable alternative to surgery.

scholarly journals Change in serum KL-6 level from baseline is useful for predicting life-threatening EGFR-TKIs induced interstitial lung disease

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Shigeo Kawase ◽  
Noboru Hattori ◽  
Nobuhisa Ishikawa ◽  
Yasushi Horimasu ◽  
Kazunori Fujitaka ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Life Threatening ◽  
Egfr Tkis
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