Giordano Giuseppe, Fanzone Luigi, Meo Diego, Piana Sebastiano, Lentini Viviana, Borracino Savino, Potenza Enrico, Magnano San Lio Vincenzo
Unit of Diagnostic and Interventional Radiology ARNAS "Garibaldi-Nesima", Catania, Catania, Italy.
Radiology Unit 1, Department of Medical Surgical Sciences and Advanced Technologies - University Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy.
Radiol Case Rep. 2021 Jul 2;16(9):2437-2441. doi: 10.1016/j.radcr.2021.05.059. eCollection 2021 Sep.
We report the case of a woman with a mass in the anterior and middle mediastinum (a non-small-cell lung carcinoma), determining significant compression of both superior vena cava and right pulmonary artery. The patient developed acute respiratory distress syndrome , necessitating intubation and admission to the Intensive Care Unit . Radiotherapy sessions to reduce the mass effect were attempted, without significant clinical improvement. Due to the persistence of severe hypoxemia, stenting of the superior vena cava and the right pulmonary artery was performed, the latter resulting in a significant improvement of the arterial blood gas parameters, allowing extubation of the patient. In our opinion, stenting of the superior vena cava and the pulmonary artery (or its branches) is an effective and safe treatment; it should be considered in similar cases, especially if other - less invasive - treatments fail.
我们报告了一例患有前纵隔和中纵隔肿块(非小细胞肺癌)的女性病例,该肿块导致上腔静脉和右肺动脉均受到明显压迫。患者出现急性呼吸窘迫综合征,需要插管并入住重症监护病房。尝试进行放射治疗以减轻肿块效应,但临床症状无明显改善。由于严重低氧血症持续存在,对上腔静脉和右肺动脉进行了支架置入术,后者使动脉血气参数得到显著改善,患者得以拔管。我们认为,上腔静脉和肺动脉(或其分支)支架置入术是一种有效且安全的治疗方法;在类似病例中应考虑采用,尤其是在其他侵入性较小的治疗方法失败时。