Giragani Suresh, Balani Ankit, Mallu Gangadhar R, Yedlapati Gopikrishna, Maturu Venkata N, Babu V Lakshman, Alwala Surendar
Department of Interventional Radiology, Yashoda Hospitals, Hyderabad, Telangana, India.
Department of Pulmonary Medicine, Yashoda Hospitals, Hyderabad, Telangana, India.
Lung India. 2019 Jan-Feb;36(1):8-13. doi: 10.4103/lungindia.lungindia_458_17.
Pulmonary artery pseudoaneurysms are a rare cause of massive hemoptysis and need to be considered as a differential with prompt recognition preventing mortality from life-threatening hemorrhage. We report the clinical details and imaging findings for a series of patients presenting with massive haemoptysis due to peripheral pulmonary artery pseudoaneurysm, managed by endovascular glue embolization.
Hospital based retrospective study wherein records and image database of patients presenting with massive hemoptysis between January 2014 and March 2016 were studied. The immediate technical success, reintervention rate, and recurrence of massive hemoptysis were recorded.
Among patients with massive hemoptysis who underwent endovascular management in our department, seven patients fulfilled the inclusion criteria. The mean age was 54.3 years; mean lesion diameter was 10.8 mm (range 6-14 mm); underlying pathology being infective (tuberculosis) in all cases (n = 7). All lesions were treated with endovascular glue embolization. The technical success was 100%. Mean follow-up was 11.7 months. There was no case of recurrence of massive hemoptysis. There were no major complications with a single case of minor complication (in the form of chest pain and discomfort) which resolved with medical management.
The endovascular approach using glue (N-butyl cyanoacrylate) is a minimally invasive and technically feasible, effective technique for emergent management of pulmonary artery pseudoaneurysms presenting as massive hemoptysis.
肺动脉假性动脉瘤是大量咯血的罕见病因，需要作为鉴别诊断加以考虑，及时识别可预防危及生命的出血导致的死亡。我们报告了一系列因外周肺动脉假性动脉瘤导致大量咯血的患者的临床细节和影像学表现，这些患者接受了血管内胶水栓塞治疗。
基于医院的回顾性研究，研究了2014年1月至2016年3月期间出现大量咯血的患者的记录和图像数据库。记录即刻技术成功率、再次干预率和大量咯血的复发情况。
在我们科室接受血管内治疗的大量咯血患者中，7例符合纳入标准。平均年龄为54.3岁；平均病变直径为10.8mm（范围6 - 14mm）；所有病例（n = 7）的潜在病理均为感染性（结核病）。所有病变均采用血管内胶水栓塞治疗。技术成功率为100%。平均随访11.7个月。无大量咯血复发病例。无严重并发症，仅1例轻微并发症（表现为胸痛和不适），经药物治疗后缓解。
使用胶水（氰基丙烯酸正丁酯）的血管内治疗方法是一种微创、技术上可行且有效的技术，用于紧急处理表现为大量咯血的肺动脉假性动脉瘤。
