Pulmonary artery bullet embolism—Case report and review

Abstract

Symptomatic pulmonary bullet emboli should be managed with endovascular retrieval when available or operative therapy. Asymptomatic intravascular bullet emboli may be managed conservatively as seen in our patient.

Gunshot bullet embolisation in the middle cerebral artery

“…The gold standard treatment for BE when there are neurological signs is surgical removal with open and endovascular options 12. In some cases, surgical embolectomy may not be possible due to vessel size, vasospasm and iatrogenic injury 13.…”

Shotgun wound to the leg: strategies in managing acute arterial injury and bullet emboli to the heart and lungs

“…1 Optimal plan of management is controversial: treatment ranges from simple non-surgical observation to invasive percutaneous endovascular retrieval Shotgun wound to the leg: strategies in managing acute arterial injury and bullet emboli to the heart and lungs images in… or surgical removal. [1][2][3] Surgical intervention for asymptomatic patients has been deemed too dangerous by some authors, yet others report a mortality rate of 80% in patients with retained intrapulmonary artery missiles. 1 3 Surgery is recommended when bullets are contaminated by faecal matter due to bowel perforation, induce cardiac arrhythmias or cause valvular dysfunction.…”

Hybrid treatment of bullet embolism at the abdominal aortic bifurcation, complicated with thoracoabdominal aorta pseudoaneurysm and common iliac artery occlusion: case report

“…Abdominal all symptomatic injuries and all arterial damage must be treated. [2][3][4]8,9 However, discussions in the literature are ongoing with relation to management of asymptomatic venous injuries, in particular when embolism is the result of bullets lodged in one of two regions: 1-in the pulmonary circulation, without causing ischemia or pulmonary abscesses and bronchial erosion 9 ; and 2-in the right ventricle, when bullets smaller than 5 mm are firmly lodged and there is no evidence of arrhythmia or valve dysfunction. 10 In such cases, some authors recommend clinical observation.…”

“…[2][3][4] We describe a case of bullet embolization of the abdominal aorta complicated by a pseudoaneurysm of the thoracoabdominal aorta and occlusion of the right common iliac artery, which was treated using a hybrid approach.…”