Endovascular embolization prior to surgical resection of symptomatic intralobar pulmonary sequestration in an adult

Avsenik, Jernej; Štupnik, Tomaž; Popovič, Peter

doi:10.1016/j.ejro.2015.11.001

Cited by 21 publications

(28 citation statements)

References 10 publications

(34 reference statements)

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“…The systemic artery may come from the thoracic aorta or from the abdomen, especially from the celiac trunk. Usually, the communication with the bronchial tree is absent or abnormal but it might be normal in some intralobar sequestration cases (2). Patients frequently suffer from recurrent bronchopulmonary infections.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter embolization of a large aberrant systemic artery to an intralobar pulmonary sequestration using an Amplatzer vascular plug in an adolescent

Berthod¹,

Chevallier²,

Pottecher³

et al. 2017

Quant. Imaging Med. Surg.

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Section: Discussionmentioning

confidence: 99%

Transcatheter embolization of a large aberrant systemic artery to an intralobar pulmonary sequestration using an Amplatzer vascular plug in an adolescent

Berthod¹,

Chevallier²,

Pottecher³

et al. 2017

Quant. Imaging Med. Surg.

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“…Pulmonary sequestration is characterized by a rare congenital abnormality of the lower respiratory system arising from one or several aberrant systemic arteries, and accounts for 0.15–6.4% of all pulmonary malformations . Typically, it is classified into two basic types: extralobar (25% of all cases), which is separated from the lung tissue by a separate lining of pleura; and intralobar (75% of all cases), which is embedded in the normal lung and shares common pleural investment . In this case, final pathology revealed intralobar pulmonary sequestration.…”

Section: Introductionmentioning

confidence: 85%

Intralobar pulmonary sequestration originating from the intercostal arteries treated with surgical resection

Rehman

et al. 2018

Thoracic Cancer

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Intralobar pulmonary sequestration originating from the intercostal arteries is rarely reported. Herein, we report an unusual case of a 56‐year‐old male patient with intralobar pulmonary sequestration supplied from the intercostal arteries on the left lower lobe who presented after a month of a repeated cough and massive hemoptysis. Although transcatheter arterial embolization was performed three times, the patient's symptoms were not relieved. A left lower lobectomy was performed with video‐assisted thoracic surgery. At the six‐month follow‐up after surgery, the patient had recovered well without any hemoptysis. Therefore, surgical resection with lobectomy may be a better alternative to transcatheter arterial embolization for the treatment of intralobar pulmonary sequestrations arising from the intercostal arteries. To our knowledge, this is the second reported case of intralobar pulmonary sequestration arising from the intercostal arteries.

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“…Sometimes, the bulky size of these arteries ( Figure 5) and/or their multiple numbers (2) raise doubts about the long-term effectiveness of embolization. In case of massive hemoptysis, embolization followed by surgical resection appears to be effective, but these are only isolated cases (1,14). …”

Section: Discussionmentioning

confidence: 99%

“…They result from a defect in the obliteration of the splanchnic arteries during embryogenesis (1). They are divided into extralobar (ELS) and intralobar (ILS) sequestrations.…”

Section: Introductionmentioning

confidence: 99%

Adult pulmonary intralobar sequestrations: changes in the surgical management

Traibi¹,

Seguin‐Givelet²,

Brian³

et al. 2018

J. Vis. Surg.

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Background: Until now, the traditional procedure to treat intralobar pulmonary sequestration (ILS) in adults has been a lobectomy performed by open chest surgery. We have reviewed our data to determine whether the surgical management of these lesions has evolved over the last years. Methods:We retrospectively reviewed the records of patients who were operated on for an ILS by either posterolateral thoracotomy (PLT group), or by thoracoscopy (TS group) between 2000 and 2016.Results: Eighteen patients were operated on for a ILS during this period. Before 2011, all resections were performed by thoracotomy (n=6) and after 2011 the approach was either a thoracotomy (n=5) or a thoracoscopy (n=7). There was one conversion because of dense pleural adhesions and this patient was integrated in the PLT group for further analysis. ILS presented more frequently on the left side (n=12, 66.7%) than on the right one (n=6, 33.3%) and exclusively in the lower lobes. All the PLT group patients underwent a lobectomy. In the TS group, five patients underwent a sublobar resection (2 segmentectomies S9+10, 1 basilar segmentectomy and 2 atypical resections). There was no mortality. In the PLT group, 5 patients (45%) had complications versus one patient (14%) in the TS group. The mean hospital stay was 7.4 days in the PLT group versus 5.4 days in the TS group.Conclusions: These data confirm that ILS can be safely treated by a sublobar resection that should be performed, whenever possible, without opening the chest. descending thoracic abdominal aorta or even the celiac trunk, with normal venous drainage into the pulmonary veins. They are usually located in the basal segments of the lower lobes. They are covered with a normal visceral pleura shared with the adjacent healthy pulmonary parenchyma. ILS are often detected in adulthood after pulmonary infections and/or haemoptysis, and more rarely, after cardiac insufficiency by venous return overload (2). They are sometimes discovered accidentally or confused with another condition. Until recently, the treatment of ILS was exclusively surgical and was based on the interruption of the systemic artery associated with lobectomy by open chest surgery. Other surgical or non-surgical treatments have recently been proposed, aiming to be less invasive and to spare the pulmonary parenchyma. The aim of this work is to determine if the surgical management of these lesions has evolved over the last years.Methods B e t w e e n J a n u a r y 2 0 0 0 a n d D e c e m b e r 2 0 1 6 , w e retrospectively reviewed the records of patients who underwent surgery for pulmonary sequestration in our department. Clinical and demographic data including patients age, sex, preoperative symptoms, type of surgery, type of resection and postoperative course were analyzed ( Table 1). The approach was a posterolateral thoracotomy (PLT group) or an exclusive thoracoscopy (TS group) according to a standardized technique previously described in details (3). Briefly, the procedure was performed under general anesthesia with spli...

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Endovascular embolization prior to surgical resection of symptomatic intralobar pulmonary sequestration in an adult

Cited by 21 publications

References 10 publications

Transcatheter embolization of a large aberrant systemic artery to an intralobar pulmonary sequestration using an Amplatzer vascular plug in an adolescent

Transcatheter embolization of a large aberrant systemic artery to an intralobar pulmonary sequestration using an Amplatzer vascular plug in an adolescent

Intralobar pulmonary sequestration originating from the intercostal arteries treated with surgical resection

Adult pulmonary intralobar sequestrations: changes in the surgical management

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