Anomalous Systemic Arterial Supply to the Basal Segments of the Lung: Feasible Thoracoscopic Surgery

Mori, Shiro; Odaka, Makoto; Asano, Hiroaki; Marushima, Hideki; Yamashita, Makoto; Kamiya, Nobuo; Morikawa, Toshiaki

doi:10.1016/j.athoracsur.2013.04.099

Cited by 19 publications

(18 citation statements)

References 28 publications

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“…Considering the histopathological features of the aberrant artery, the presence of an elastic artery with dissection of the tunica media might be complicated when an aneurysm forms with high blood flow, which is the same as our case. Indeed, there are several reports of aneurysms of aberrant arteries leading to fatal ruptures [2,3]. Giant aberrant arteries like that of the present case carry the risk of dissection and rupture; therefore, appropriate treatment must be carried out in a timely manner following diagnosis.…”

Section: Discussionmentioning

confidence: 73%

“…In addition, we considered the possibility of concomitant pulmonary arteriovenous fistula because the aberrant artery was too large for a single disease of ABLL, and aneurysmal aberrant artery was assumed to be an effect of pulmonary arteriovenous fistula. Therefore, we performed surgical therapy to shut down abnormal blood flow and reduce the risk of rupture [3]. In addition, according to a prior report, the stump of an aberrant artery may form an aneurysm; therefore, we planned to perform left lower lobectomy with subsequent coil embolization of the remnant aberrant artery when the blood supply was confirmed postoperatively [4].…”

Section: Case Presentationmentioning

confidence: 99%

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Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report

et al. 2020

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Background Anomalous systemic arterial supply to the basal segment of the lung (ABLL) is a relatively rare congenital anomaly characterized by aberrant systemic arterial blood flow to the basal segment of the lung. We experienced a rare presentation of ABLL, in which a giant aberrant artery with the same dimensions as that of the descending aorta flowed from the celiac artery to left lower lobe. Case presentation An otherwise healthy 42-year-old man was referred to our department due to an abnormal chest X-ray. Enhanced computed tomography revealed a huge and winding aberrant artery with mural thrombus originating from the celiac artery and perfusing into the left lower lobe. We diagnosed giant ABLL and considered possible concomitant pulmonary arteriovenous fistula. The diameter of the aberrant artery was > 30 mm and high-pressure flow was assumed; therefore, we performed staged resection of the left lower lobectomy including division of the aberrant artery at the pulmonary ligament and subsequent embolization of the remnant arterial flow uneventfully. Pathologically, the aberrant artery was abundant with elastic fibers, and dissections of the tunica media and mural thrombus were observed; however, arteriovenous fistula was not confirmed. At 6 postoperative months, enhanced computed tomography showed the aberrant artery to be completely occluded without any symptoms. Conclusions We present a case of ABLL that was successfully managed by surgical resection of the left lower lobe with most of the giant aberrant artery and subsequent embolization of the remnant portion. Our study demonstrates that a staged surgical therapy is an acceptable approach for ABLL in case of complication with a giant aberrant artery.

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Section: Discussionmentioning

confidence: 73%

Section: Case Presentationmentioning

confidence: 99%

Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report

et al. 2020

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“… 9 Transarterial embolization has been suggested as an alternative option to lobectomy or segmentectomy, even in cases with only isolated systemic artery supply, as a case series demonstrated that the incidence of pulmonary infarction is low and there were no severe consequences on long-term follow-up. 10 Although treatment has been conventionally recommended, there are reports of patients electing for monitoring. 5,8 Without long-term follow-up of these patients and given the rarity and variability of the disease the best treatment option is debateable.…”

Section: Discussionmentioning

confidence: 99%

An easily overlooked cause of haemoptysis and heart failure; anomalous systemic arterial supply to normal lung

2020

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Systemic arterial supply to a segment of normal lung is rare. 1 Usually the anomalous systemic artery arises from the descending aorta, although it can arise from other sites including the coeliac axis. 1–3 Case reports documenting an anomalous artery to normal lung from the coeliac axis are few. However, in these cases the patients were being investigated for respiratory symptoms and all were under the age of 50. In our case, we describe a rare case of anomalous systemic arterial supply arising from the coeliac axis to the right lower lobe, in the absence of abnormal bronchial connection or parenchymal disease in an asymptomatic patient. The anomalous arterial supply was an incidental finding on CT. The literature suggests surgical treatment to prevent symptoms of haemoptysis or congestive cardiac failure, but it is unclear from current evidence whether this is indicated in an asymptomatic patient.

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“…Recently, there have also been reports of the use of thoracoscopic surgery [5] and vascular blockade technique with clips [6]. Furthermore, intravascular embolization with a coil was reported [7].…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular coil embolization in an elder and asymptomatic case of anomalous systemic arterial supply to the normal basal segment

Machida

Motono

Matsui

et al. 2017

International Journal of Surgery Case Reports

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HighlightsAn anomalous systemic arterial supply to the normal basal segment without sequestration is a rare congenital vascular malformation.We experienced a case of successful endovascular embolization of in an elderly and asymptomatic patient with an anomalous systemic arterial supply to the normal basal segment.Coil embolization is a very useful treatment method for elderly patients with an anomalous systemic arterial supply to the normal basal segment.

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Anomalous Systemic Arterial Supply to the Basal Segments of the Lung: Feasible Thoracoscopic Surgery

Cited by 19 publications

References 28 publications

Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report

Anomalous systemic arterial supply to the basal segment of the lung with giant aberrant artery: a case report

An easily overlooked cause of haemoptysis and heart failure; anomalous systemic arterial supply to normal lung

Successful endovascular coil embolization in an elder and asymptomatic case of anomalous systemic arterial supply to the normal basal segment

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