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Treatment of massive hemoptysis after thoracic aortic aneurysm repair

BACKGROUND: Massive hemoptysis after thoracic aortic aneurysm (TAA) repair is a rare but potentially lethal condition. Endovascular management is a challenging treatment option due to the complexity of culprit vessel access. CASE PRESENTATION: An 81-year-old woman was referred to our hospital with m...

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Autores principales: Morimura, Fumio, Hamamoto, Kohei, Edo, Hiromi, Ishida, Osamu, Tsustsumi, Koji, Tamada, Soichiro, Kuwamura, Hiroshi, Enjoji, Yasuhiro, Suyama, Yohsuke, Sugiura, Hiroaki, Watanabe, Sadahiro, Ozaki, Ippei, Shinmoto, Hiroshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924344/
https://www.ncbi.nlm.nih.gov/pubmed/35290529
http://dx.doi.org/10.1186/s42155-022-00293-3
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author Morimura, Fumio
Hamamoto, Kohei
Edo, Hiromi
Ishida, Osamu
Tsustsumi, Koji
Tamada, Soichiro
Kuwamura, Hiroshi
Enjoji, Yasuhiro
Suyama, Yohsuke
Sugiura, Hiroaki
Watanabe, Sadahiro
Ozaki, Ippei
Shinmoto, Hiroshi
author_facet Morimura, Fumio
Hamamoto, Kohei
Edo, Hiromi
Ishida, Osamu
Tsustsumi, Koji
Tamada, Soichiro
Kuwamura, Hiroshi
Enjoji, Yasuhiro
Suyama, Yohsuke
Sugiura, Hiroaki
Watanabe, Sadahiro
Ozaki, Ippei
Shinmoto, Hiroshi
author_sort Morimura, Fumio
collection PubMed
description BACKGROUND: Massive hemoptysis after thoracic aortic aneurysm (TAA) repair is a rare but potentially lethal condition. Endovascular management is a challenging treatment option due to the complexity of culprit vessel access. CASE PRESENTATION: An 81-year-old woman was referred to our hospital with massive hemoptysis. She had a history of graft replacement and thoracic endovascular aortic repair (TEVAR) for dissecting TAA. Computed tomography (CT) showed massive atelectasis with hematoma in the left lower lung lobe adjacent to the descending aortic aneurysm treated with TEVAR. Contrast-enhanced CT revealed a pseudoaneurysm and proliferation of abnormal vessels at the peripheral side of the left pulmonary ligament artery (PLA) in the atelectasis. The PLA continued to the right subscapular artery via a complex collateral pathway. Diagnostic angiography of the right subcapsular artery revealed a pseudoaneurysm and abnormal vessels at the peripheral side of the left PLA with a systemic-pulmonary artery shunt. Transcatheter arterial embolization (TAE) for the left PLA via the collateral pathway with N-butyl cyanoacrylate achieved complete embolization. The patient’s hemoptysis was controlled and she was discharged. CONCLUSIONS: Here we presented a case of massive hemoptysis due to PLA disruption that occurred after TAA repair. TAE via a complex collateral pathway is a feasible and effective treatment for hemoptysis, even in patients who have undergone surgical or endovascular TAA repair.
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spelling pubmed-89243442022-04-01 Treatment of massive hemoptysis after thoracic aortic aneurysm repair Morimura, Fumio Hamamoto, Kohei Edo, Hiromi Ishida, Osamu Tsustsumi, Koji Tamada, Soichiro Kuwamura, Hiroshi Enjoji, Yasuhiro Suyama, Yohsuke Sugiura, Hiroaki Watanabe, Sadahiro Ozaki, Ippei Shinmoto, Hiroshi CVIR Endovasc Case Report BACKGROUND: Massive hemoptysis after thoracic aortic aneurysm (TAA) repair is a rare but potentially lethal condition. Endovascular management is a challenging treatment option due to the complexity of culprit vessel access. CASE PRESENTATION: An 81-year-old woman was referred to our hospital with massive hemoptysis. She had a history of graft replacement and thoracic endovascular aortic repair (TEVAR) for dissecting TAA. Computed tomography (CT) showed massive atelectasis with hematoma in the left lower lung lobe adjacent to the descending aortic aneurysm treated with TEVAR. Contrast-enhanced CT revealed a pseudoaneurysm and proliferation of abnormal vessels at the peripheral side of the left pulmonary ligament artery (PLA) in the atelectasis. The PLA continued to the right subscapular artery via a complex collateral pathway. Diagnostic angiography of the right subcapsular artery revealed a pseudoaneurysm and abnormal vessels at the peripheral side of the left PLA with a systemic-pulmonary artery shunt. Transcatheter arterial embolization (TAE) for the left PLA via the collateral pathway with N-butyl cyanoacrylate achieved complete embolization. The patient’s hemoptysis was controlled and she was discharged. CONCLUSIONS: Here we presented a case of massive hemoptysis due to PLA disruption that occurred after TAA repair. TAE via a complex collateral pathway is a feasible and effective treatment for hemoptysis, even in patients who have undergone surgical or endovascular TAA repair. Springer International Publishing 2022-03-15 /pmc/articles/PMC8924344/ /pubmed/35290529 http://dx.doi.org/10.1186/s42155-022-00293-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Morimura, Fumio
Hamamoto, Kohei
Edo, Hiromi
Ishida, Osamu
Tsustsumi, Koji
Tamada, Soichiro
Kuwamura, Hiroshi
Enjoji, Yasuhiro
Suyama, Yohsuke
Sugiura, Hiroaki
Watanabe, Sadahiro
Ozaki, Ippei
Shinmoto, Hiroshi
Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title_full Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title_fullStr Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title_full_unstemmed Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title_short Treatment of massive hemoptysis after thoracic aortic aneurysm repair
title_sort treatment of massive hemoptysis after thoracic aortic aneurysm repair
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8924344/
https://www.ncbi.nlm.nih.gov/pubmed/35290529
http://dx.doi.org/10.1186/s42155-022-00293-3
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