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血管内线圈迁移至支气管:文献综述及两例病例报告

Intravascular coil migration to bronchus: review of the literature with two case reports.

作者信息

Yetkin Nur Aleyna, Tutar Nuri

机构信息

Clinic of Chest Diseases, Kayseri Training and Research Hospital, Kayseri, Turkey.

Department of Chest Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey.

出版信息

Tuberk Toraks. 2019 Dec;67(4):307-313. doi: 10.5578/tt.69010.

Abstract

Pulmonary vascular abnormalities are important causes of hemoptysis. Arteriovenous malformation (AVM), pulmonary arterial aneurysms or invasion of the pulmonary arterial structures by the tumor may cause hemoptysis. Pulmonary artery aneurysms (PAA) are an infrequent disease of the pulmonary vasculature. Endovascular coil application is a convenient treatment option for the treatment of hemoptysis due to vascular anomalies. The migration of intravascular coil to another tissue is a rare complication. To review this extremely rare complication, herein we report two unusual cases who had pulmonary artery aneurysm and who had hemoptysis due to tumor invasion to pulmonary artery, initially treated with endovascular coil successfully. In both cases endovascular coil was migrated to the bronchus subsequently. Lobectomy may be performed in such cases with coil migration into the bronchus or conservative therapy with follow-up chest imaging may be a suitable treatment option for selected patients. The choice of treatment should be made individually for each patient considering the characteristics of the patients. In patients with coils, the biopsy can lead to massive hemorrhages that are fatal.

摘要

肺血管异常是咯血的重要原因。动静脉畸形(AVM)、肺动脉瘤或肿瘤侵犯肺动脉结构都可能导致咯血。肺动脉瘤(PAA)是一种罕见的肺血管疾病。血管内线圈置入是治疗因血管异常引起咯血的一种便捷治疗选择。血管内线圈迁移至另一组织是一种罕见的并发症。为了回顾这一极其罕见的并发症,我们在此报告两例不寻常的病例,这两名患者患有肺动脉瘤且因肿瘤侵犯肺动脉而咯血,最初成功接受了血管内线圈置入治疗。在这两例病例中,血管内线圈随后均迁移至支气管。对于线圈迁移至支气管的此类病例,可进行肺叶切除术,或者对部分患者进行保守治疗并进行胸部影像学随访可能是合适的治疗选择。应根据每位患者的特点为其个体化选择治疗方案。对于体内有线圈的患者,活检可能导致致命的大出血。

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