Limits...
Bronchial artery embolization in chronic pulmonary thromboembolism: A therapeutic dilemma.

Sharma M, Garg M, Ghuman MS, Kocchar R, Khandelwal N - Lung India (2015 Nov-Dec)

Bottom Line: Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis.Management of hemoptysis in chronic PTE is a point of debate.In this article, we have reported one case of hemoptysis in chronic PTE managed successfully with bronchial artery embolization.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.

ABSTRACT
Bronchial artery embolization is the treatment of choice for the management of life-threatening massive hemoptysis. Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis. Management of hemoptysis in chronic PTE is a point of debate. In this article, we have reported one case of hemoptysis in chronic PTE managed successfully with bronchial artery embolization.

No MeSH data available.


Related in: MedlinePlus

(a, b) Coronal maximum intensity projection (MIP) images of CT bronchial angiography showing hypertrophied right bronchial arteries (arrows in a). One of the bronchial arteries was arising from the intercostobronchial trunk from the descending aorta (not shown here). Origin of the second right bronchial artery was, however, not clear on CT angiography. A thrombus was seen in the right pulmonary artery (arrow in b) extending till the subsegmental branches
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4663871&req=5

Figure 1: (a, b) Coronal maximum intensity projection (MIP) images of CT bronchial angiography showing hypertrophied right bronchial arteries (arrows in a). One of the bronchial arteries was arising from the intercostobronchial trunk from the descending aorta (not shown here). Origin of the second right bronchial artery was, however, not clear on CT angiography. A thrombus was seen in the right pulmonary artery (arrow in b) extending till the subsegmental branches

Mentions: A 30-year-old male patient presented to the emergency department of our institute with recurrent bouts of hemoptysis for 1 week, along with shortness of breath. The patient had expectoration of ~100 mL of fresh blood/day. On examination, he was found to have tachycardia (pulse rate: 100 bpm) and tachypnea (respiratory rate: 30 breaths/min) with decreased oxygen saturation (85% in room air). The patient underwent computed tomography (CT) and bronchial angiography that showed two bronchial arteries on the right side, which were hypertrophied and tortuous (measuring ~2.6 mm and 2.4 mm, respectively, in maximum caliber) [Figure 1a]. The left bronchial artery was normal. No significant nonbronchial systemic collateral was seen. In addition, there was a thrombus in the right pulmonary artery, extending from its origin till the subsegmental branches [Figure 1b]. The right pulmonary artery was reduced in caliber with the dilated main and left pulmonary arteries. Patchy areas of mosaic attenuation were also seen in bilateral lungs. Two-dimensional echocardiogram (2D ECHO) was done for the patient that showed severe PAH with dilated right atrium and ventricle. On bronchoscopy, active bleeding with clots was seen in the segmental bronchus of the right lower lobe.


Bronchial artery embolization in chronic pulmonary thromboembolism: A therapeutic dilemma.

Sharma M, Garg M, Ghuman MS, Kocchar R, Khandelwal N - Lung India (2015 Nov-Dec)

(a, b) Coronal maximum intensity projection (MIP) images of CT bronchial angiography showing hypertrophied right bronchial arteries (arrows in a). One of the bronchial arteries was arising from the intercostobronchial trunk from the descending aorta (not shown here). Origin of the second right bronchial artery was, however, not clear on CT angiography. A thrombus was seen in the right pulmonary artery (arrow in b) extending till the subsegmental branches
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663871&req=5

Figure 1: (a, b) Coronal maximum intensity projection (MIP) images of CT bronchial angiography showing hypertrophied right bronchial arteries (arrows in a). One of the bronchial arteries was arising from the intercostobronchial trunk from the descending aorta (not shown here). Origin of the second right bronchial artery was, however, not clear on CT angiography. A thrombus was seen in the right pulmonary artery (arrow in b) extending till the subsegmental branches
Mentions: A 30-year-old male patient presented to the emergency department of our institute with recurrent bouts of hemoptysis for 1 week, along with shortness of breath. The patient had expectoration of ~100 mL of fresh blood/day. On examination, he was found to have tachycardia (pulse rate: 100 bpm) and tachypnea (respiratory rate: 30 breaths/min) with decreased oxygen saturation (85% in room air). The patient underwent computed tomography (CT) and bronchial angiography that showed two bronchial arteries on the right side, which were hypertrophied and tortuous (measuring ~2.6 mm and 2.4 mm, respectively, in maximum caliber) [Figure 1a]. The left bronchial artery was normal. No significant nonbronchial systemic collateral was seen. In addition, there was a thrombus in the right pulmonary artery, extending from its origin till the subsegmental branches [Figure 1b]. The right pulmonary artery was reduced in caliber with the dilated main and left pulmonary arteries. Patchy areas of mosaic attenuation were also seen in bilateral lungs. Two-dimensional echocardiogram (2D ECHO) was done for the patient that showed severe PAH with dilated right atrium and ventricle. On bronchoscopy, active bleeding with clots was seen in the segmental bronchus of the right lower lobe.

Bottom Line: Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis.Management of hemoptysis in chronic PTE is a point of debate.In this article, we have reported one case of hemoptysis in chronic PTE managed successfully with bronchial artery embolization.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, Punjab and Haryana, India.

ABSTRACT
Bronchial artery embolization is the treatment of choice for the management of life-threatening massive hemoptysis. Chronic pulmonary thromboembolism (PTE) is one of the rare causes of hemoptysis. Management of hemoptysis in chronic PTE is a point of debate. In this article, we have reported one case of hemoptysis in chronic PTE managed successfully with bronchial artery embolization.

No MeSH data available.


Related in: MedlinePlus