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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

Digital subtraction angiogram of the right intercostobronchial trunk (anteroposterior projection) showing hypertrophied and tortuous bronchial artery. Embolization was done using PVA- gelfoam slurry. Postembolization angiogram showed no opacification of the distal bronchial artery (image on the right side)
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Figure 2: Digital subtraction angiogram of the right intercostobronchial trunk (anteroposterior projection) showing hypertrophied and tortuous bronchial artery. Embolization was done using PVA- gelfoam slurry. Postembolization angiogram showed no opacification of the distal bronchial artery (image on the right side)

Mentions: The patient was taken up for bronchial angiography. Selective run showed hypertrophied and tortuous right intercostobronchial trunk [Figure 2]. The second bronchial artery was being reconstituted by the internal mammary artery and was hypertrophied [Figure 3]. Both the bronchial arteries were embolized with polyvinyl alcohol (PVA) (500-700 μm) and gelfoam slurry. No other significant systemic collateral was identified on diagnostic runs of the bilateral subclavian arteries. The procedure was uneventful. Postprocedure improvement in oxygen saturation was seen with a decrease in oxygen requirement. No fresh episode of hemoptysis occurred. The patient was started on anticoagulation for chronic PTE and was discharged.


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)

Digital subtraction angiogram of the right intercostobronchial trunk (anteroposterior projection) showing hypertrophied and tortuous bronchial artery. Embolization was done using PVA- gelfoam slurry. Postembolization angiogram showed no opacification of the distal bronchial artery (image on the right side)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Digital subtraction angiogram of the right intercostobronchial trunk (anteroposterior projection) showing hypertrophied and tortuous bronchial artery. Embolization was done using PVA- gelfoam slurry. Postembolization angiogram showed no opacification of the distal bronchial artery (image on the right side)
Mentions: The patient was taken up for bronchial angiography. Selective run showed hypertrophied and tortuous right intercostobronchial trunk [Figure 2]. The second bronchial artery was being reconstituted by the internal mammary artery and was hypertrophied [Figure 3]. Both the bronchial arteries were embolized with polyvinyl alcohol (PVA) (500-700 μm) and gelfoam slurry. No other significant systemic collateral was identified on diagnostic runs of the bilateral subclavian arteries. The procedure was uneventful. Postprocedure improvement in oxygen saturation was seen with a decrease in oxygen requirement. No fresh episode of hemoptysis occurred. The patient was started on anticoagulation for chronic PTE and was discharged.

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