Transarterial embolization of intralobar pulmonary sequestration in a young adult with hemoptysis

Abstract

Intralobar pulmonary sequestration is a rare congenital malformation characterized by the presence of dysplastic lung that does not communicate with the tracheobronchial tree, and has aberrant systemic arterial supply. While most are asymptomatic, they rarely can present with hemoptysis, which has been traditionally managed with surgical resection of the sequestration. We report a case of an 18-year-old male who presented with acute large-volume hemoptysis on a background of recurrent minor episodes of hemoptysis, due to intralobar sequestration. He was successfully treated with transarterial embolization with a combination of polyvinyl alcohol (PVA) particles, gelfoam and coils. Transarterial embolization can be effective in managing emergent hemoptysis from pulmonary sequestration.

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

“…Furthermore, very few studies have compared the results of embolization and surgical resection and reported which treatment is better in adult patients . Some authors believe that embolization can occlude the arterial supply, leading to sequestration infarction, and thus is an alternative treatment method to conventional surgical resection . As such, embolization is thought by some to be superior to surgery as it minimizes complications and shortens hospital stay …”

“…12 Some authors believe that embolization can occlude the arterial supply, leading to sequestration infarction, and thus is an alternative treatment method to conventional surgical resection. 10 As such, embolization is thought by some to be superior to surgery as it minimizes complications and shortens hospital stay. 13 An adverse effect of embolization is the distant migration of embolization products resulting in the embolization of non-targeted arteries.…”

Possibilities of Using Miniinvasive Catheter Technologies in the Treatment of Lung Bleeding

“…Treatment of pulmonary bleeding is still one of the most pressing problems in surgery. Pulmonary bleeding is the most dangerous complication of a number of diseases [1,2]. There are 40 nosological forms that can be complicated by pulmonary hemorrhage (PH); some authors describe PH as a complication in more than 100 diseases [3,4].…”

“…To date, X-ray vascular occlusion (REO) of the bronchial arteries allows patients to avoid surgery at the height of bleeding. Despite the fact that this method has been used in clinical practice for more than 30 years, the questions concerning the tactics of interventions and the choice of embolizing materials [14,15]. Efficiency of the method in the long-term period is devoted to the publications.…”

Pulmonary sequestration mimicking lung abscess in old age

“…In cases with severe infected ILS, segmentectomy or ligation of the aberrant artery is insufficient with a favour for lobectomy to avoid contamination . In cases of ILS with arteriovenous shunting and heart failure, endovascular embolization is a viable alternative to surgery, while the surgical resection is a preferred strategy for cases with recurrent chest infection …”