Sequestro pulmonar e tratamento endovascular: um relato de caso

Abstract

Resumo O sequestro pulmonar refere-se à anomalia congênita definida por massa de parênquima pulmonar não funcionante. É dividido pela existência de envoltório pleural próprio em intralobar, representando cerca de 75% dos casos, ou extralobar, responsável pelos 25% restantes. O diagnóstico é feito através de radiografia e confirmado com tomografia computadorizada, ressonância nuclear magnética e arteriografia. Tradicionalmente, o tratamento proposto é cirúrgico, mas a técnica endovascular tem apresentado bons resultados. É relatado o caso de uma mulher, 29 anos, com quadro clínico de pneumonias de repetição desde os 5 anos. A tomografia de tórax revelou malformação vascular em região inferior de pulmão direito. O tratamento vascular foi realizado através de embolização do ramo anômalo.

Imaging and pathological characteristics, treatment, and prognosis of pulmonary sequestration—A retrospective study of 13 cases

“…For patients with pulmonary sequestration and surgical contraindications, interventional embolization of arteries with an abnormal blood supply can be considered, but its effectiveness and safety require further study. [24][25][26][27] With the exception of patients with pulmonary sequestration and clear surgery-related contraindications, minimally invasive thoracoscopic surgery is the preferred treatment for pulmonary sequestration. Compared to traditional thoracotomy, minimally invasive thoracoscopic surgery has the advantages of a small incision, less intraoperative bleeding, faster postoperative recovery, and shorter postoperative hospital stay.…”

“…For patients with pulmonary sequestration and surgical contraindications, interventional embolization of arteries with an abnormal blood supply can be considered, but its effectiveness and safety require further study 24–27 . With the exception of patients with pulmonary sequestration and clear surgery‐related contraindications, minimally invasive thoracoscopic surgery is the preferred treatment for pulmonary sequestration.…”

Extralobar pulmonary sequestration: A case report and literature review

“…This less invasive treatment modality has fewer complications. 22 Currently a thoracic endograft can be used for PS. 23 We can consider thoracic endograft as a firstline treatment because this treatment has the least physiological burden on the patient and the fastest recovery 24 or we can perform vascular embolization with Glubran (nbutyl cyanoacrylate), an endovascular technique that may be a less invasive alternative for patients with comorbidities or who have refused surgery.…”

“…Reviewing the relevant literature, with the intensive research on PS in recent years, the treatment modalities have become diversified and endovascular treatment is another option available. This less invasive treatment modality has fewer complications 22 . Currently a thoracic endograft can be used for PS 23 .…”