A case of bronchiectasis with right middle lobe resection after embolization of bronchial artery, inferior phrenic artery, and internal thoracic artery with severe shunt with middle lobe pulmonary artery

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.

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Transcatheter Embolization of Systemic-to-pulmonary Artery Fistulas: a Case Report

10.21203/rs.3.rs-1004874/v1 ◽

2021 ◽

Author(s):

Shen Zhang ◽

Jun Qian

Keyword(s):

Pulmonary Artery ◽

Arterial Embolization ◽

Lung Parenchyma ◽

Transcatheter Embolization ◽

Bronchial Arteries ◽

Pulmonary Vessel ◽

Inferior Phrenic Artery ◽

Systemic Artery ◽

Phrenic Artery ◽

Pulmonary Artery Fistula

Abstract The systemic artery to pulmonary vessel fistula(SAPVF) is an uncommon vascular abnormal communication between systemic arteries (except bronchial arteries) and the lung parenchyma[1]. It can be divided into congenital and acquired causes. Congenital SAPVF is often accompanied by cardiac or pulmonary artery hypoplasia, and acquired are usually caused by pleural adhesions after pleurisy, empyema, trauma, or surgery[2].We report a case of transcatheter arterial embolization for the treatment of congenital right inferior phrenic artery to pulmonary artery fistula.

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Life-threatening hemoptysis due to left inferior phrenic artery to pulmonary artery fistula rescued by extracorporeal membrane oxygenation therapy

Interactive Cardiovascular and Thoracic Surgery ◽

10.1510/icvts.2010.255265 ◽

2011 ◽

Vol 12 (2) ◽

pp. 337-338 ◽

Cited By ~ 4

Author(s):

S.-J. Hsu ◽

Y.-H. Luo ◽

Y.-C. Lee ◽

K.-Y. Yang

Keyword(s):

Pulmonary Artery ◽

Extracorporeal Membrane Oxygenation ◽

Inferior Phrenic Artery ◽

Membrane Oxygenation ◽

Life Threatening ◽

Phrenic Artery ◽

Pulmonary Artery Fistula

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Perforation of the right pulmonary artery branch to the right middle lobe with a Swan-Ganz catheter during cardiopulmonary bypass, resulting in endobronchial hemorrhage

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)36888-6 ◽

1991 ◽

Vol 102 (5) ◽

pp. 807-808 ◽

Cited By ~ 7

Author(s):

Andrew S. Olearchyk ◽

Annapoorna Varada

Keyword(s):

Cardiopulmonary Bypass ◽

Pulmonary Artery ◽

Middle Lobe ◽

Pulmonary Artery Branch ◽

Right Pulmonary Artery ◽

Right Middle Lobe ◽

The Right ◽

Artery Branch

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Systemic Artery-to-Pulmonary Artery Fistula Mimics Pulmonary Embolus

Journal of Clinical Imaging Science ◽

10.25259/jcis_54_2019 ◽

2019 ◽

Vol 9 ◽

pp. 41

Author(s):

David Livingston ◽

Matthew Grove ◽

Rolf Grage ◽

J. Mark McKinney

Keyword(s):

Pulmonary Artery ◽

Pulmonary Embolus ◽

Lower Lobe ◽

Filling Defect ◽

Inferior Phrenic Artery ◽

Arterial Blood ◽

Systemic Artery ◽

Phrenic Artery ◽

The Right ◽

Pulmonary Artery Fistula

Systemic artery-to-pulmonary artery fistula (SA-PAF) is a rare phenomenon that can resemble a filling defect on computed tomography angiography (CTA). SA-PAF can be due to congenital or acquired etiologies and can alter the hemodynamics of the pulmonary circulation, with the most serious reported complication being hemoptysis, requiring embolization. We describe a case of an unusual SA-PAF between the right inferior phrenic artery and the right lower lobe pulmonary artery that mimicked an unprovoked pulmonary embolus (PE) on standard CTA in a patient with cardiomyopathy. This SA-PAF was interpreted on CTA as PE due to the presence of a filling defect, revealing that not all filling defects are PE. SA-PAF should always be considered when the clinical context or the imaging findings are atypical, specifically with an isolated filling defect visualized in the inferior lower lobe pulmonary artery. The false-positive PE was the result of mixing of systemic non-opacified blood with opacified pulmonary arterial blood.

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