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Title: Transarterial Embolization of Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung

Abstract

PurposeTo evaluate transarterial embolization (TAE) for the management of anomalous systemic arterial (ASA) supply to normal basal segments of the lung.MethodsThirteen patients with ASA supply to normal basal segments of the lung underwent TAE. All patients presented with hemoptysis and had complete-type anomalies on pre-TAE or post-TAE computed tomography (CT). The anomaly was unilateral in all patients; 11 lesions were located in the left lung and 2 in the right. All patients underwent embolization with coils (n = 10) or a vascular plug (n = 3). Procedural success, clinical efficacy, and complications were assessed. Mean post-TAE CT and clinical follow-up was 25.4 and 42.1 months, respectively.ResultsTechnical success was achieved in 100 % of cases. Several changes were noted on follow-up CT: complete obstruction of the ASA in all cases, normal (n = 11) or decreased (n = 2) density of the affected lung parenchyma, reduction of the primary enlarged inferior pulmonary vein in all cases, and pulmonary infarction and thickening of the corresponding bronchial artery (n = 4). The main complication was pulmonary infarction in four cases.ConclusionTAE is a safe, effective, and minimally invasive therapeutic option for patients with ASA supply to normal basal segments of the lung.

Authors:
; ;  [1]
  1. Tongji University School of Medicine, Department of Radiology, Shanghai Pulmonary Hospital (China)
Publication Date:
OSTI Identifier:
22645461
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 9; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ARTERIES; COMPUTERIZED TOMOGRAPHY; LUNGS; PATIENTS; VASCULAR DISEASES; VEINS

Citation Formats

Jiang, Sen, E-mail: jasfly77@vip.163.com, Yu, Dong, and Jie, Bing. Transarterial Embolization of Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1361-Y.
Jiang, Sen, E-mail: jasfly77@vip.163.com, Yu, Dong, & Jie, Bing. Transarterial Embolization of Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung. United States. doi:10.1007/S00270-016-1361-Y.
Jiang, Sen, E-mail: jasfly77@vip.163.com, Yu, Dong, and Jie, Bing. 2016. "Transarterial Embolization of Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung". United States. doi:10.1007/S00270-016-1361-Y.
@article{osti_22645461,
title = {Transarterial Embolization of Anomalous Systemic Arterial Supply to Normal Basal Segments of the Lung},
author = {Jiang, Sen, E-mail: jasfly77@vip.163.com and Yu, Dong and Jie, Bing},
abstractNote = {PurposeTo evaluate transarterial embolization (TAE) for the management of anomalous systemic arterial (ASA) supply to normal basal segments of the lung.MethodsThirteen patients with ASA supply to normal basal segments of the lung underwent TAE. All patients presented with hemoptysis and had complete-type anomalies on pre-TAE or post-TAE computed tomography (CT). The anomaly was unilateral in all patients; 11 lesions were located in the left lung and 2 in the right. All patients underwent embolization with coils (n = 10) or a vascular plug (n = 3). Procedural success, clinical efficacy, and complications were assessed. Mean post-TAE CT and clinical follow-up was 25.4 and 42.1 months, respectively.ResultsTechnical success was achieved in 100 % of cases. Several changes were noted on follow-up CT: complete obstruction of the ASA in all cases, normal (n = 11) or decreased (n = 2) density of the affected lung parenchyma, reduction of the primary enlarged inferior pulmonary vein in all cases, and pulmonary infarction and thickening of the corresponding bronchial artery (n = 4). The main complication was pulmonary infarction in four cases.ConclusionTAE is a safe, effective, and minimally invasive therapeutic option for patients with ASA supply to normal basal segments of the lung.},
doi = {10.1007/S00270-016-1361-Y},
journal = {Cardiovascular and Interventional Radiology},
number = 9,
volume = 39,
place = {United States},
year = 2016,
month = 9
}
  • No abstract prepared.
  • We report the case of a 24-year-old woman with systemic arterial supply to the normal basal segments of the left lower lobe of the lung. She experienced repeated episodes of hemoptysis. In this patient, the normal pulmonary arteries were absent in the affected segments. The aberrant artery arising from the descending thoracic aorta was embolized using metallic coils. The patient's recovery was uneventful, except that she had mild chest pain for 3 days after the procedure. Her symptom has not recurred since 1 year follow-up. Although proximal occlusion of the aberrant artery was observed, pulmonary infarction or necrosis of themore » affected segments was not shown on follow-up computed tomography. Transarterial embolization can be an alternative treatment option for patients with this rare congenital anomaly.« less
  • An anomalous systemic artery originating from the descending thoracic aorta supplying the normal basal segments of the lower lobe of the left lung without sequestration is a rare congenital anomaly. The published surgical treatments include lobectomy, segmentectomy, anastomosis, and ligation. In addition, endovascular treatment with coils has been reported. A second-generation occluder, the Amplatzer Vascular Plug II (AVP II), has a central plug and two occlusion disks and a finer, more densely woven nitinol wire, thus enabling faster embolization. This published case is the first successful occlusion of an aneurysm of an anomalous systemic artery with the AVP II andmore » fibered coils, with 10 months of follow-up.« less
  • We report the case of a 17-year-old man with acute chest pain due to a partial thrombosis of a pseudo sequestration. Unlike a true sequestration, there was a normal bronchial distribution and the involved lung parenchyma was normal on CT scan. A therapeutic transarterial embolization of the aberrant systemic artery from the proximal abdominal aorta was performed successfully. The patient did not suffer from further chest pain during the follow-up of 12 months. A contrast-enhanced CT scan 4 months later demonstrated complete occlusion of the embolized aberrant artery. Our case represents an alternative treatment to surgery for this rare abnormality.
  • Scimitar syndrome is a rare congenital disorder. It is characterized by partial or total abnormal venous drainage of the right lung into the inferior vena cava, which is often associated with anomalous systemic arterial supply to the right lung, congenital cardiac anomalies, hypoplasia of the right lung and bronchial anomalies. Symptoms depend on the degree of the shunt and severity of the associated anomalies, which determine the treatment. We present a 6-year-old boy who was diagnosed as having the adult form of scimitar syndrome during evaluation for recurrent pulmonary infections, and underwent embolization with a detachable silicon balloon of themore » anomalous systemic arterial supply from the abdominal aorta to the right lower lung lobe. Successful elective surgery was performed 6 months later, in which right pulmonary veins were directed to the left atrium using a Gore-Tex patch by creating an intra-atrial tunnel. The patient has been symptom-free period during 6 months of follow-up, which supports the idea that recurrent pulmonary infections can be eliminated by embolization of the anomalous arterial supply.« less