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Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature

BACKGROUND: Exposure to crystalline silica results in silicosis with initiation and progression of pulmonary fibrosis. The impaired lung parenchyma leads to pulmonary arterial hypertension and increased pressure in the right ventricle of the heart. Usually, the silicosis may be followed by enlargeme...

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Autores principales: Zhang, Ruifeng, Ma, Guofeng, Xu, Xiaoling, Liang, Li
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943882/
https://www.ncbi.nlm.nih.gov/pubmed/29480834
http://dx.doi.org/10.1097/MD.0000000000009469
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author Zhang, Ruifeng
Ma, Guofeng
Xu, Xiaoling
Liang, Li
author_facet Zhang, Ruifeng
Ma, Guofeng
Xu, Xiaoling
Liang, Li
author_sort Zhang, Ruifeng
collection PubMed
description BACKGROUND: Exposure to crystalline silica results in silicosis with initiation and progression of pulmonary fibrosis. The impaired lung parenchyma leads to pulmonary arterial hypertension and increased pressure in the right ventricle of the heart. Usually, the silicosis may be followed by enlargement of hilar lymphnodes, but silicosis-induced pulmonary artery stenosis with severe pulmonary hypertension is rare. Percutaneous pulmonary artery stenting and balloon angioplasty were performed to relieve stenosis and pulmonary hypertension. METHODS: We report the case of a 52-year-old man who was admitted for persistent dyspnea for 2 years and progressive dyspnea for half a month. He had been a stonemason for 20 years. The computer tomography pulmonary angiography scan images showed partially fibrotic lungs with a disseminated nodular pattern and enlarged bilateral hilar and mediastinal lymphnodes. The echocardiogram and right heart catheterization confirmed the diagnosis of severe pulmonary arterial hypertension. RESULTS: Pulmonary angiograms showed severe stenosis of the proximal upper right and lower left pulmonary artery. Moderate stenosis occured in a branch of the lower right pulmonary artery and a branch of the upper left pulmonary artery. A total of 2 stents and 4 balloons were used to relieve lesions. The final angiograms showed a significantly increased pulmonary artery caliber. The clinical symptom and 6-minute walk distance of the patient were much improved. CONCLUSION: To our knowledge, this is the first reported case of percutaneous treatment for silicosis-induced pulmonary artery stenosis and pulmonary hypertension. The clinical symptom, 6-minute walking test, and vessel caliber at areas of stenosis improved significantly following stent implantation and balloon dilatation. However, the patient was followed up for a short period and long-term outcomes have not yet been sufficiently evaluated.
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spelling pubmed-59438822018-05-15 Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature Zhang, Ruifeng Ma, Guofeng Xu, Xiaoling Liang, Li Medicine (Baltimore) Research Article BACKGROUND: Exposure to crystalline silica results in silicosis with initiation and progression of pulmonary fibrosis. The impaired lung parenchyma leads to pulmonary arterial hypertension and increased pressure in the right ventricle of the heart. Usually, the silicosis may be followed by enlargement of hilar lymphnodes, but silicosis-induced pulmonary artery stenosis with severe pulmonary hypertension is rare. Percutaneous pulmonary artery stenting and balloon angioplasty were performed to relieve stenosis and pulmonary hypertension. METHODS: We report the case of a 52-year-old man who was admitted for persistent dyspnea for 2 years and progressive dyspnea for half a month. He had been a stonemason for 20 years. The computer tomography pulmonary angiography scan images showed partially fibrotic lungs with a disseminated nodular pattern and enlarged bilateral hilar and mediastinal lymphnodes. The echocardiogram and right heart catheterization confirmed the diagnosis of severe pulmonary arterial hypertension. RESULTS: Pulmonary angiograms showed severe stenosis of the proximal upper right and lower left pulmonary artery. Moderate stenosis occured in a branch of the lower right pulmonary artery and a branch of the upper left pulmonary artery. A total of 2 stents and 4 balloons were used to relieve lesions. The final angiograms showed a significantly increased pulmonary artery caliber. The clinical symptom and 6-minute walk distance of the patient were much improved. CONCLUSION: To our knowledge, this is the first reported case of percutaneous treatment for silicosis-induced pulmonary artery stenosis and pulmonary hypertension. The clinical symptom, 6-minute walking test, and vessel caliber at areas of stenosis improved significantly following stent implantation and balloon dilatation. However, the patient was followed up for a short period and long-term outcomes have not yet been sufficiently evaluated. Wolters Kluwer Health 2018-01-12 /pmc/articles/PMC5943882/ /pubmed/29480834 http://dx.doi.org/10.1097/MD.0000000000009469 Text en Copyright © 2018 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle Research Article
Zhang, Ruifeng
Ma, Guofeng
Xu, Xiaoling
Liang, Li
Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title_full Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title_fullStr Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title_full_unstemmed Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title_short Percutaneous treatment for silicosis-induced pulmonary artery stenosis: A case report and review of the literature
title_sort percutaneous treatment for silicosis-induced pulmonary artery stenosis: a case report and review of the literature
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943882/
https://www.ncbi.nlm.nih.gov/pubmed/29480834
http://dx.doi.org/10.1097/MD.0000000000009469
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