Clinical characteristics and postoperative outcomes of systemic artery-to-pulmonary vessel fistula in hemoptysis patients

Zhang, Chujie; Jiang, Faming; Zuo, Zhili; Li, Shanshan; Zhao, Ying; Li, Peijun; Ye, Dong-Fan; Zhang, Lanlan; Tong, Lihong; Chen, Songlin; Li, Haiming; Luo, Fengming; Wang, Ye

doi:10.1007/s00330-021-08484-7

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…In our study, 13 patients in the observation group in had hemoptysis symptoms of different degrees before surgery, and all patients were treated with regional systemic artery embolization before surgery to relieve hemoptysis symptoms. The lesions of tuberculous in the lung spread widely, forming close adhesion with intercostal arteries, subclavian vessels, parietal pleura, and other sites ( 23 ), with repeated infection, vasodilation, and abundant collateral circulation occurring. During the treatment, as reported in previous literature ( 24 ), we also found that all patients in the observation group had blood supply from body arteries other than bronchial arteries ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

Wang¹,

Jiang²,

Zhang³

et al. 2023

J Thorac Dis

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Background: The patients with tuberculosis-destroyed lungs often have heavy adhesion in the affected side of the pleural cavity and abundant collateral circulation, which bring about considerable challenges to surgical treatment. Some patients with tuberculosis-destroyed lungs will have hemoptysis symptoms. In clinical work, we found that patients with hemoptysis before surgery due to hemoptysis through regional artery occlusion treatment often have less bleeding during surgery, and it is relatively easy to stop bleeding during surgery, and the operation time is short. This study mainly used retrospective comparative cohort studies to explore the clinical efficacy of combined surgical treatment after regional systemic artery embolization pretreatment of tuberculosis-destroyed lung and provides a basis for further optimizing the surgical treatment of tuberculosis-destroyed lung.Methods: From June 2021 to September 2022, 28 patients with tuberculosis-destroyed lungs who underwent surgery in our department from the same medical group were selected. The patients were divided into 2 groups according to whether regional arterial embolization was introduced before surgery. In the observation group (n=13), before surgery, all patients received arterial embolization in the target area for hemoptysis, and surgery was performed 24-48 h after embolization. In the control group (n=15), direct surgical treatment was performed without embolization. The factors including operation time, intraoperative blood loss, and postoperative complication rates were compared between the 2 groups to assess the value of regional artery embolization combined with surgery in the treatment of tuberculosis-destroyed lung.Results: There was no significant difference between the 2 groups in general condition and disease condition, including age, duration of disease, location of lesion, and operation method (P>0.05). The operation time in the observation group was shorter than that in the observation group (P<0.05), the amount of intraoperative bleeding in the observation group was lower than that in the control group (P<0.05). The incidence of postoperative complications including pulmonary infection, anemia, and hypoproteinemia in the observation group was lower than that in the control group (P<0.05). Conclusions: Regional arterial embolism preconditioning combined with surgical operation may reduce the risk of conventional surgical treatment, shorten the operation time, and reduce postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

Wang¹,

Jiang²,

Zhang³

et al. 2023

J Thorac Dis

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“…Recent study by Zhang et al have reported clinical characteristics and outcomes of BAE performed in 184 SA-PAF cases ( 26 ). They defined SA-PAF based on radiographic appearance on digital subtraction angiography (DSA) with characteristics of an axifugal blood flow, smaller sized caliber with denser contrast filling, sharper vessel wall borders, and dichotomous branching patterns.…”

Section: Discussionmentioning

confidence: 99%

CT evaluation of systemic artery to pulmonary artery fistula: an underdiagnosed disease in patients with hemoptysis

Woo,

Cha,

Lee

et al. 2023

J Thorac Dis

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Background Systemic artery to pulmonary artery fistula (SA-PAF) is an uncommon disease which is often incidentally diagnosed during evaluation of hemoptysis patients. The aim of our study was to describe the cases of SA-PAF in our institution and to report the correlating clinical and radiological findings. Methods We reviewed 231 chest computed tomography (CT) scans performed in our institution due to hemoptysis from January 2020 to February 2023. In patients diagnosed with SA-PAF had their electronic medical records and CT images analyzed. Results In 231 patients, 19 (8.2%) of them had SA-PAF findings which was characterized by a peripheral nodular soft tissue opacity in the subpleural lung and traceable vascular structure in continuity with one or more peripheral pulmonary artery branches in CT. Etiology of each patient was categorized as either congenital (7, 36.8%), and acquired (12, 63.2%). The origins of SA-PAFs were 16 intercostal, two anterior mediastinal, and one costocervical artery. Eight of 19 patients did not show any associated intralobar imaging abnormalities, while bronchiectasis, cellular bronchiolitis, centrilobular emphysema, and pleura effusion were observed in 11 patients. Conclusions SA-PAF is a benign vascular anomaly which is frequently overlooked when evaluating hemoptysis by either clinician or radiologists but is an important factor in the differential diagnosis of patients with hemoptysis.

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“…Tumor staining and degree of SPS were evaluated by three experienced radiologists following methods of previous studies ( Nakanishi et al, 2008 ; Nakanishi et al, 2012 ; Takeuchi et al, 2020 ; C. J. Zhang et al, 2022 ). Next, all confirmed relevant arteries underwent super-selective catheterization with a coaxial microcatheter system that used 4F or 5F outer catheters.…”

Section: Methodsmentioning

confidence: 99%

“…Second, angiography was performed through various types of 4F or 5F catheters following the CTA through the femoral artery access to confirm the feeding arteries. Tumor staining and degree of SPS were evaluated by three experienced radiologists following methods of previous studies (Nakanishi et al, 2008;Nakanishi et al, 2012;Takeuchi et al, 2020;C. J. Zhang et al, 2022).…”

Section: Therapeutic Processmentioning

confidence: 99%

Clinical outcomes of vinorelbine loading CalliSpheres beads in the treatment of previously treated advanced lung cancer with progressive refractory obstructive atelectasis

Zheng

Zhang

et al. 2022

Front. Bioeng. Biotechnol.

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Background: Drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) has been used in the treatment of locally advanced lung cancer and has the potential to improve outcomes and reduce recurrence. However, DEB-BACE shows a poor therapeutic effect in advanced lung cancer after failure of multiple therapies. This study assessed the effect of DEB-BACE in the treatment of progressive lung cancer with refractory obstructive atelectasis.Methods: Progressive advanced lung cancer patients with refractory obstructive atelectasis were voluntarily enrolled in this study after failure of multiple conventional therapies. Baseline information, DEB-BACE treatment process, and changes in clinical symptoms were recorded. The primary endpoints were the objective response rate (ORR) and improvement rate of dyspnea. The secondary endpoints were time-to-progression (TTP), overall survival (OS), and rate of pulmonary re-expansion. Treatment-related adverse events and serious adverse events were analyzed to assess the safety of DEB-BACE. The Cox regression model was performed to analyze the possible factors impacting prognosis of DEB-BACE.Results: DEB-BACE was successfully performed with CalliSpheres beads loaded with vinorelbine in the 20 enrolled patients. ORR and disease control rate were 80% and 85%, respectively, at the first follow-up (43.4 ± 15.26 days). The improvement rate of dyspnea was 85% and 80% at 1 week and 1 month (p < 0.0001, p < 0.0001), respectively. TTP was 41.25 ± 14.43 days and 89.55 ± 61.7 days before and after DEB-BACE, respectively; DEB-BACE delayed the progression of advanced lung cancer (p < 0.0001). OS was 238.03 ± 33.74 days (95% confidence interval: 171.9–304.16). The rate of pulmonary re-expansion was 80% at the first follow-up. The reasons for poor prognosis were tumor necrosis, longer disease duration, and pulmonary atelectasis duration (p = 0.012, p = 0.038, p = 0.029). Massive hemoptysis was observed in two cases, and one patient died of asphyxia caused by hemoptysis. Moderate hemoptysis occurred in one case. All three adverse events were considered as the result of the tumor cavity after DEB-BACE.Conclusion: DEB-BACE loaded with vinorelbine is a feasible option for progressive advanced lung cancer with obstructive atelectasis after failure of other treatments.

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Clinical characteristics and postoperative outcomes of systemic artery-to-pulmonary vessel fistula in hemoptysis patients

Cited by 5 publications

References 23 publications

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

Comparison of clinical effects between regional arterial embolization combined with surgery and simple surgery in the treatment of tuberculosis-destroyed lung—a retrospective comparative cohort study

CT evaluation of systemic artery to pulmonary artery fistula: an underdiagnosed disease in patients with hemoptysis

Clinical outcomes of vinorelbine loading CalliSpheres beads in the treatment of previously treated advanced lung cancer with progressive refractory obstructive atelectasis

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