Lutz Noémie, Grange Sylvain, Sanson Christian, Grange Rémi
Department of Radiology, University Hospital of Saint-Etienne, France.
Department of Pneumology, University Hospital of Saint-Etienne, France.
Radiol Case Rep. 2021 Feb 24;16(5):1068-1071. doi: 10.1016/j.radcr.2021.02.029. eCollection 2021 May.
Hemoptysis could be a life-threatening event, especially when the bleeding originates from the arterial pulmonary circulation. The main cause of this type of bleeding is pulmonary artery pseudoaneurysm (PAP), which can be managed by surgical, medical or minimally invasive techniques. This study reports the case of massive hemoptysis in a 75-year-old male patient, with a former history of lobectomy. The initial CT scan showed a giant PAP from a branch of the right middle lobar pulmonary artery, within the right lower lobectomy cavity. An endovascular approach was decided. Subsequently, the feeding artery of the PAP was embolized with detachable coils. The control CT scan showed a persistent opacification of the PAP. The embolization was then completed by injection of Onyx within coils packing, with a complete thrombose of the PAP on control CT scan. This report confirms the safety and efficacy profile of an endovascular approach to treat giant PAP, using a combination of coils and Onyx.
咯血可能是危及生命的事件，尤其是当出血源自肺循环动脉时。此类出血的主要原因是肺动脉假性动脉瘤（PAP），可通过手术、药物或微创技术进行处理。本研究报告了一名75岁男性患者大量咯血的病例，该患者既往有肺叶切除术史。最初的CT扫描显示在右下肺叶切除腔内，右中叶肺动脉分支处有一个巨大的PAP。决定采用血管内介入方法。随后，用可脱卸线圈栓塞PAP的供血动脉。对照CT扫描显示PAP持续存在不透明影。然后通过在已填充线圈内注射Onyx完成栓塞，对照CT扫描显示PAP完全血栓形成。本报告证实了联合使用线圈和Onyx的血管内介入方法治疗巨大PAP的安全性和有效性。
