Therapeutic embolization of a systemic arterialization of lung without sequestration

Abstract

We report the case of a 51-year-old man with massive haemoptysis due to a systemic arterialization of lung without sequestration. Unlike bronchopulmonary sequestration there was a normal bronchial distribution and the involved lung parenchyma was normal. Therefore a therapeutic transarterial embolization of the aberrant systemic vessel from the distal thoracic aorta was performed. The embolization was successful and the patient did not suffer from further haemoptysis during the subsequent follow-up of ten months. A postembolization aortogram 6 months later demonstrated a complete occlusion of the embolized aberrant artery; in the lung perfusion scan there was only a small perfusion defect, but normal ventilation in the embolized basal part of the left lower lobe. Our case represents an alternative treatment to surgery for this rare anomaly.

Transarterial Embolization Treatment for Aberrant Systemic Arterial Supply to the Normal Lung: A Case Report and Literature Review

“…Diagnosis is relatively easy with chest computed tomography (CT) (1,2). However, treatment options vary, including surgical resection of the involved lung and surgical ligation of the aberrant artery, and endovascular treatment has been recently introduced (3). We reported a case of a 24-year-old man with ASANL who was treated by the endovascular method.…”

Systemic arterial supply to the normal basal segments of the left lower lobe treated by coil embolization, with long-term follow-up

“…[1][2][3][4][5][6][7][8] The aberrant artery commonly arises from the descending thoracic aorta, as in our case, and sometimes from the proximal abdominal aorta or the celiac artery. [1][2][3]9,10 Pryce classified intralobar sequestration into three types according to the extent of the blood supply. An abnormal artery without bronchopulmonary sequestration is categorized as type 1; an abnormal artery supplying the sequestered plus adjacent normal lung is categorized as type 2; and an abnormal artery supplying only the sequestered lung is categorized as type 3.…”

“…3,9,10 Transarterial therapeutic coil embolization of such an artery was first reported by Bruhlmann et al in 1998 in a patient whose lung was supplied by both the aberrant artery and the pulmonary artery. 3 In 2002, Chabbert et al reported a similar patient with preserved pulmonary arterial flow in whom transient chest pain occurred within a few days after embolization. 10 Izzillo et al reported a case of true Pryce type l sequestration in 2000, in which the pulmonary artery was absent.…”

“…Many reports of surgical treatment for this anomaly have been published, and generally the result had been satisfactory. 3,5,[9][10][11][12] It is likely that video-assisted thoracotomy may replace the ordinal thoracotomy.…”

Intralobar pulmonary sequestration receiving arterial supply from the superior mesenteric artery: A case report

“…In some cases with massive hemorrhage transarterial embolization of the abnormal vessels is performed [10]. Contrast-enhanced MR angiography makes it easy to obtain the preoperative vascular map needed for this kind of surgery and TAE.…”