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冠状动脉-支气管动脉瘘导致长期肺结核患者出现大量咯血。

Coronary to bronchial artery fistula causing massive hemoptysis in patients with longstanding pulmonary tuberculosis.

机构信息

Department of Radiology, Hallym University College of Medicine, Gyeonggi-do 431-070, Korea.

出版信息

Korean J Radiol. 2012 Jan-Feb;13(1):102-6. doi: 10.3348/kjr.2012.13.1.102. Epub 2011 Dec 23.

DOI:10.3348/kjr.2012.13.1.102
PMID:22247644
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3253394/
Abstract

We report on three cases of longstanding pulmonary tuberculosis patients with coronary to bronchial artery fistula (CBF) who presented with recurrent massive hemoptysis. The first and second patients died because of decreased functional pulmonary volume plus massive hemoptysis and cannulation failure of CBF due to hypovolemic vasospasm, respectively. When recurrent hemoptysis occurs despite successful embolization treatment, CBF should be considered as a potential bleeding source. Moreover, a coronary angiography should be performed, especially in patients with longstanding cardiopulmonary disease such as pulmonary tuberculosis.

摘要

我们报告了三例长期肺结核患者合并冠状至支气管动脉瘘（CBF），他们均表现为反复大咯血。第一例和第二例患者分别因功能性肺容积减少合并大咯血和低血容量性血管痉挛导致 CBF 插管失败而死亡。即使栓塞治疗成功后仍发生反复咯血，应考虑 CBF 为潜在的出血源。此外，特别是对于患有长期心肺疾病（如肺结核）的患者，应进行冠状动脉造影检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/d97fabe4b836/kjr-13-102-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/62b22eaf444f/kjr-13-102-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/cb749d293a29/kjr-13-102-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/9a7e732f25ab/kjr-13-102-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/d97fabe4b836/kjr-13-102-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/62b22eaf444f/kjr-13-102-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/cb749d293a29/kjr-13-102-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/9a7e732f25ab/kjr-13-102-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a0e8/3253394/d97fabe4b836/kjr-13-102-g004.jpg

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本文引用的文献

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Peripheral pulmonary arterial pseudoaneurysms: therapeutic implications of endovascular treatment and angiographic classifications.周围性肺假性动脉瘤：血管内治疗的治疗意义和血管造影分类。
Radiology. 2010 Aug;256(2):656-64. doi: 10.1148/radiol.10091416.
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Transcatheter embolization of bronchial artery arising from left circumflex coronary artery in a patient with massive hemoptysis.经导管栓塞发自左回旋支冠状动脉的支气管动脉治疗大咯血 1 例。
Cardiovasc Intervent Radiol. 2010 Feb;33(1):169-72. doi: 10.1007/s00270-009-9576-9. Epub 2009 Apr 23.
3
Coronary-to-bronchial artery fistula: demonstration by 64-multidetector computed tomography with retrospective electrocardiogram-gated reconstructions.
慢性肺部疾病中冠状动脉至支气管动脉交通的冠状动脉CT表现
Int J Cardiovasc Imaging. 2015 Jun;31 Suppl 1:69-75. doi: 10.1007/s10554-015-0647-5. Epub 2015 Mar 24.
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Coronary artery-bronchial artery fistulas: report of two Dutch cases with a review of the literature.冠状动脉-支气管动脉瘘：两例荷兰病例报告并文献复习。
Neth Heart J. 2014 Apr;22(4):139-47. doi: 10.1007/s12471-014-0518-z.
冠状动脉至支气管动脉瘘：64层螺旋计算机断层扫描结合回顾性心电图门控重建的显示
J Comput Assist Tomogr. 2008 May-Jun;32(3):444-7. doi: 10.1097/RCT.0b013e318123837c.
4
Bronchial to coronary artery fistulas: an important sign of silent coronary artery disease and potential complication during bronchial artery embolization.支气管至冠状动脉瘘：隐匿性冠状动脉疾病的重要征象及支气管动脉栓塞术期间的潜在并发症。
Acta Radiol. 2007 Mar;48(2):171-2. doi: 10.1080/02841850601089136.
5
Localized bronchiectasis is a definite association of coronaro-bronchial artery fistula.局限性支气管扩张与冠状动脉-支气管动脉瘘存在明确关联。
J Invasive Cardiol. 2003 Sep;15(9):554-6.
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Radiographics. 2002 Nov-Dec;22(6):1395-409. doi: 10.1148/rg.226015180.
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Coronary-to-bronchial artery communication: report of two patients successfully treated by embolization.冠状动脉至支气管动脉交通：两例经栓塞成功治疗患者的报告。
Cardiovasc Intervent Radiol. 1999 May-Jun;22(3):251-4. doi: 10.1007/s002709900377.
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