Search

Scimitar syndrome is a rare condition characterized by partial or complete anomalous pulmonary venous drainage of the lung to the inferior vena cava, right lung hypoplasia and dextroposition of the heart. Haemoptysis is uncommon in adults, although the clinical spectrum is wide. We report a case of a 38-year-old male with scimitar syndrome who had low grade haemoptysis persisting over several years secondary to bronchiectatic changes in his hypoplastic right lung. Conservative measures to manage haemoptysis were unsuccessful and the patient proceeded to bronchial artery embolization. The post-procedure course was complicated by lung infarction and the patient ultimately required pneumonectomy. Deformities of the blood vessels and lungs are complex in scimitar syndrome. Bronchial artery embolization should be approached cautiously to protect pulmonary perfusion. [ABSTRACT FROM AUTHOR]

A 64‐year‐old man presented to the emergency department with a chief complaint of epigastric pain that improved with vomiting. He was initially treated for gastrointestinal disease, but computed tomography (CT) showed a mediastinal haematoma and contrast‐enhanced CT and bronchial arteriography showed a bronchial aneurysm. Bronchial artery aneurysm is a rare but potentially life‐threatening condition that can lead to haemorrhagic shock if it ruptures. Patients with bronchial aneurysms may present with symptoms similar to that of gastrointestinal diseases owing to increased pressure in the mediastinum caused by mediastinal haematoma. [ABSTRACT FROM AUTHOR]

Bronchial artery embolization is a feasible option for treating hemoptysis caused by foreign objects in patients who are not candidates for surgery. [ABSTRACT FROM AUTHOR]

Endobronchial resection using a bronchoscope is often selected as treatment for carcinoid tumors located in the central airways. However, massive bleeding is one of the most serious complications during bronchoscopic surgery. Here, we report the case of a 77-year-old female with a typical carcinoid tumor located in the right truncus intermedius who underwent bronchial artery embolization (BAE) one day before endobronchial intervention using a flexible bronchoscope. The tumor was successfully resected without bleeding. BAE prior to endobronchial resection of carcinoid tumors may be useful for reducing the risk of bleeding. [ABSTRACT FROM AUTHOR]

Importance: Pediatric hypervascular primary airway tumors are progressive, fatal lesions with a low incidence, and the disease is often more serious than that in adults. Objective: To evaluate the clinical efficacy and safety of interventional therapeutic bronchoscopy combined with conservative treatment and bronchial arterial embolization in children with primary airway tumors. Methods: We retrospectively analyzed the clinical data of four pediatric patients with hypervascular primary airway tumor between 2017 and 2019 at Beijing Children's Hospital. Results: Two patients were low‐grade bronchial mucoepidermoid carcinoma, one patient was pleomorphic adenoma, and one was bronchial leiomyoma. Interventional therapeutic bronchoscopy combined with bronchial arterial embolization was used for treatment (all four patients received general anesthesia). The tumors were safely resected in all patients via interventional bronchoscopy. There were no severe complications related to the procedures. All patients were followed up for 5–12 months, and one low‐grade bronchial mucoepidermoid carcinoma recurred. Interpretation: Interventional therapeutic bronchoscopy combined with bronchial arterial embolization appears to be a safe and efficient therapeutic method associated with less trauma and fewer complications, including no serious adverse events, in children with hypervascular primary airway tumors without bronchus wall infiltration. [ABSTRACT FROM AUTHOR]

The confirmation of the improvement of endobronchial lesions in addition to that of vascular lesions after bronchial artery embolization of primary racemose hemangioma could be important. [ABSTRACT FROM AUTHOR]

Background and Aims Hemoptysis in children is a rare but potentially life-threatening symptom of an underlying respiratory tract abnormality. Hemoptysis, when massive and untreated, has a mortality rate of more than 50%. With interventional radiological procedures and surgery, this rate has dropped to 7%-18%. The experience with bronchial arterial embolization in childhood is very limited; only a few case reports with short-term follow-up have been reported. Methods We report herein two patients with massive hemoptysis due to abnormal systemic arterial bleeding of the lung; neither patient had any lung or systemic disease. In both cases, the bleeding was controlled with endovascular embolization. The first case had bronchopulmonary arterial anastomosis and represents the first reported case with this anomaly. The second case had recurrent massive hemoptysis due to bronchial artery bleeding, and repeat embolization was performed. Results Both of these children had rare vascular anomalies without parenchymal lung disease and were treated successfully with bronchial arterial embolization. Conclusion Massive hemoptysis due to abnormal systemic bleeding of the lung in the absence of parenchymal disease is an uncommon and severe symptom in childhood. Embolization can be a treatment option in children with abnormal vasculature bleeding and can be repeated safely when needed. [ABSTRACT FROM AUTHOR]

Introduction The studies on hemoptysis have focused mainly on hemoptysis causes and massive or life-threatening hemoptysis. And there is a limited data that non-massive hemoptysis, especially moderate hemoptysis. Objectives We analyzed the prognosis and severity of bleeding on flexible bronchoscopy ( FB) between moderate and massive hemoptysis. Methods We reviewed total 852 subjects (59.9 ± 16.0 years) identified with hemoptysis. Reviewed database included severity of subjective hemoptysis, bleeding on FB, comorbid conditions, time from admission to bronchial artery embolization ( BAE), recurrent hemoptysis and mortality. Results In subjective hemoptysis, recurrent hemoptysis occurred in mild 8.0%, moderate 40.7%, massive hemoptysis 33.8%, and mortality was 4.7%, 13.4% and 13.5%. Especially, no statistical difference was shown in recurrent hemoptysis [hazard ratio ( HR) = 0.795; 95% confidence interval ( CI) 0.562-1.125, P = 0.196] and mortality ( HR = 1.054; 95% CI 0.596-1.864, P = 0.856) between moderate and massive hemoptysis. In moderate hemoptysis patients, oozing or active bleeding on FB took up 83.3%. In this review, recurrent hemoptysis was more in oozing bleeding than active bleeding ( HR = 1.781; 95% CI 1.214-2.431, P = 0.002), but mortality was similar ( HR = 1.611; 95% CI 0.930-2.790, P = 0.089). Recurrent hemoptysis significantly decreased in the group with BAE performed within 24 h ( HR = 0.308; 95% CI 0.149-0.637, P = 0.001) in moderate hemoptysis. Also, recurrent hemoptysis and mortality were significantly increased in the patients with smoking (≥40 pack-years), oozing or active bleeding on FB, and hypertension. Conclusion Moderate hemoptysis has shown similar prognosis of recurrent hemoptysis and mortality to massive hemoptysis. Therefore, the more aggressive FB and BAE should be considered in moderate hemoptysis. [ABSTRACT FROM AUTHOR]

SummaryThree children with cystic fibrosis (CF) had significant pulmonary haemorrhage during anaesthetic induction prior to bronchial artery embolization (BAE). Haemorrhage was associated with rapid clinical deterioration and subsequent early death. We believe that the stresses associated with intermittent positive pressure ventilation (IPPV) were the most likely precipitant to rebleeding and that the inability to clear blood through coughing was also an important factor leading to deterioration. Intermittent positive pressure ventilation should be avoided when possible in children with CF with recent significant pulmonary haemorrhage. [ABSTRACT FROM AUTHOR]

A 54-year-old male presented with haemoptysis. Bronchial arteriography revealed a bent, meandering and dilated bronchial artery with vascular hyperplasia in multiple locations. The patient was diagnosed as having primary racemose haemangioma of the bronchial artery. Using a microcatheter, TorconNB (5 Fr) and Progreat (2.7 Fr), selective gelfoam embolization of the descending branch of the right bronchial artery was performed using the double catheter method. This approach would allow effective treatment of the haemorrhage and avoid spinal cord injury. [ABSTRACT FROM AUTHOR]

Herein, we report two cases of erratic coil migration from the bronchial artery to the bronchus after bronchial artery embolization (BAE). Neither patient exhibited haemoptysis recurrence, but chest radiographs revealed that part of the coil had disappeared. In Case 1, the patient coughed up the coil 4.5 years after BAE. We performed repeat BAE to minimize the possibility of haemoptysis considering bronchoscopic and angiographic findings. In Case 2, the patient had severe dry cough 2 years after BAE. Chest radiography showed migrated coils in the trachea; bronchoscopy revealed a migrated fragment of the coil protruding from the elevated mucosa. We used a loop cutter to split the coil and then removed it using forceps. Coil migration to the bronchus is an infrequent late‐stage complication of super‐selective bronchial artery coil embolization, and only one other case has been reported. Accordingly, we propose treatment strategies and speculate on the mechanism of fistula formation. [ABSTRACT FROM AUTHOR]