Vascular intervention in the thorax: bronchial artery embolization for haemoptysis

Marshall, T.; Jackson, James E.

doi:10.1007/s003300050279

Cited by 103 publications

(92 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We also avoided using liquid embolic agents (Absolute ethanol, glues) because they cause the occlusion of the capillary network, leading to tissue necrosis. [23][24][25] The choice of embolization material is among the most important steps in the procedure of BAE. This primarily refers to the material properties that determine the duration of the embolization effect, and to the size of the particles employed (350-500 µm), which taken together ensure a long-term haemoptysis control.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter embolization of bronchial arteries in the treatment of haemoptysis

Vidjak¹,

Novačić²,

Hebrang³

et al. 2009

Radiology and Oncology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Transcatheter embolization of bronchial arteries in the treatment of haemoptysis

Vidjak¹,

Novačić²,

Hebrang³

et al. 2009

Radiology and Oncology

View full text Add to dashboard Cite

show abstract

“…It is essential to avoid material smaller than 325 lm in diameter, as it can pass through bronchopulmonary anastomoses and lead to pulmonary infarction or systemic arterial embolism (via anastomoses between bronchial arteries and pulmonary artery or vein, respectively) [18]. By the same token, it is as important to avoid embolic agents that cause distal occlusion to such an extent that normal peripheral branches supplying the bronchi, esophagus, aorta, and pulmonary artery might be equally occluded, leading to obviously catastrophic complications [19]. For all of these reasons, when bronchial artery embolization is contemplated, we recommend the use of microparticles ranging in diameter from 350 to 700 lm [20].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Embolization of Hypervascular Castleman’s Disease of the Mediastinum

Robert

Sgourdos

Kritikos

et al. 2007

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

We report the case of a 31-year-old woman with mediastinal CastlemanÕs disease of the hyaline vascular type. This large tumor was safely resected after arterial embolization. We describe the steps of this interventional procedure and discuss related necessary precautions.Key words: CastlemanÕs disease-Hypervasular tumors-Mediastinum-Arterial embolization CastlemanÕs disease (CD) is a rare form of lymph node hyperplasia, most commonly presenting as a solitary mediastinal mass. Computed tomography (CT) and angiographic features of CD are nonspecific [1] and a definite diagnosis is only based on histology findings. The surgical approach is usually curative when the disease is unicentric [2], but it is frequently associated with profuse bleeding. Only a few previous reports have suggested arterial embolization in the preoperative management of CD [3,4]. We report a case of localized CD presenting as a voluminous mass in the posterior mediastinum. Preoperative arterial embolization of this tumor minimized intraoperative bleeding. Case ReportA 31-year-old nonsmoking Asian woman with no medical history presented with a dry cough for 6 months without any other symptoms. An abnormal opacity in the posterior mediastinum was found on chest X-ray (Figs. 1A and 1B). CT confirmed the presence of a 12-cm homogeneous, welldelineated hypervascular right paravertebral mass of the posterior mediastinum (Fig. 1C). There was no evidence of pleural fluid or bone invasion. Laboratory investigations were within the normal range. Fine-needle aspiration or needle-core biopsy was not performed considering the risk of bleeding from this hypervascular mass and because of its location.A preoperative descending thoracic aortogram was obtained by means of a 5F pigtail catheter (Cordis, Roden, The Netherlands), in order to visualize the origin of the bronchial and extrabronchial arteries from the aorta. A selective bronchial arteriography by means of a 5F steam-modified Cobra catheter (Cordis, Roden, The Netherlands) supported the presence of a hypervascular mediastinal mass. The lesion was exclusively supplied by two arterial branches of a broncho-intercostal trunk originating from the descending thoracic aorta; it drained into large uphill inferior esophageal varices (Fig. 2). In a second step, embolization of these two feeding arteries was performed, in order to minimize intraoperative bleeding. The superior arterial branch, which supplied the superior and lateral portions of the mass, was selectively catheterized with a 2.5F microcatheter (Tracker 18; Boston Scientific, Cork, Ireland) and embolized by means of gelatin cross-linked tris-acryl microspheres 500-750 lm in diameter (Embospheres; Biosphere Medical, Roissy-Charles-de-Gaulle, France). Occlusion of the proximal segment was completed by three 3-0 silk threads (Silkam; Aesculap, Tuttlingen, Germany). The second arterial branch, which supplied the inferior and medial portions of the mass, was superselectively catheterized beyond the left bronchial artery and embolized in the sa...

show abstract

“…83 Severe hemoptysis leading to uncontrolled bleeding and sudden death appears to be uncommon, with a mortality rate exceeding 50% if appropriate treatment is not immediately provided. [84][85][86][87][88] The source of massive hemoptysis 89 is predominantly the bronchial circulation (90%), rather than the pulmonary circulation (5%), and in a minority of cases it may originate from the aorta or the systemic arterial supply to the lungs. [90][91][92] In PAH the hypoxic vasoconstriction and the intravascular thrombosis 93 reduce pulmonary circulation, resulting in bronchial artery proliferation and enlargement.…”

Section: Hemoptysismentioning

confidence: 99%

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Demerouti

Manginas²,

Athanassopoulos

et al. 2012

Respir Care

View full text Add to dashboard Cite

SummaryPulmonary arterial hypertension (PAH) is a disease of small pulmonary arteries, characterized by vascular proliferation and remodeling. Progressive increase in pulmonary vascular resistance ultimately leads to right ventricular heart failure and death. PAH-specific drug therapy has improved clinical outcomes and survival. While the survival is better, progression of pulmonary vasculopathy contributes to pulmonary artery dilatation. Left main compression syndrome, pulmonary artery dissection, pulmonary artery rupture, and severe hemoptysis are reported as complications leading to sudden cardiac death, an event encountered more often in PAH patients. The advent of PAHtargeted drug therapy has reduced referral for lung transplantation; however, severe complications require rapid diagnosis, decision making, and possible registration on a lung transplantation waiting list. PAH referral centers provide multidisciplinary emergency care and specific therapeutic management, contributing to improved quality of life and survival for PAH patients. We review the complications leading to sudden death in PAH. Key words: pulmonary hypertension; pulmonary artery dissection; pulmonary artery rupture; left main compression syndrome. [Respir Care 2013;58(7):1246 -1254.

show abstract

Vascular intervention in the thorax: bronchial artery embolization for haemoptysis

Cited by 103 publications

References 9 publications

Transcatheter embolization of bronchial arteries in the treatment of haemoptysis

Transcatheter embolization of bronchial arteries in the treatment of haemoptysis

Preoperative Embolization of Hypervascular Castleman’s Disease of the Mediastinum

Complications Leading to Sudden Cardiac Death in Pulmonary Arterial Hypertension

Contact Info

Product

Resources

About