Marine Leopoldo, Torrealba Jose Ignacio, Valdes Francisco, Mertens Renato, Vargas Francisco, Bergoeing Michel, Vallejos Daniel
Pontificia Universidad Católica de Chile, Escuela de Medicina, Santiago, Chile.
J Vasc Bras. 2022 May 23;21:e20190160. doi: 10.1590/1677-5449.201901602. eCollection 2022.
Endovascular embolization of arteries feeding pulmonary sequestrations is a growing therapeutic option. A 51-year-old woman with chest pain and hemoptysis was admitted. During hospitalization she presented 150 mL hemoptysis, hypotension, and hematocrit fell to 23.3%. Contrast-enhanced computed tomography confirmed a pulmonary sequestration irrigated by an aneurysmal artery from the abdominal aorta. The patient underwent endovascular coil embolization of the artery feeding the aneurysm and an Amplatzer device was deployed in the proximal third of the sequestration artery. Subsequent contrast-enhanced computed tomography confirmed complete thrombosis of the aberrant artery feeding the aneurysm and absence of irrigation of the pulmonary sequestration. At 56 months follow-up the patient remains asymptomatic, tomography showed involution of the sequestration and complete thrombosis of the aberrant artery. The challenges presented by the different treatment alternatives are discussed.
对供应肺隔离症的动脉进行血管内栓塞是一种日益受到青睐的治疗选择。一名51岁胸痛伴咯血的女性入院。住院期间，她出现150毫升咯血、低血压，血细胞比容降至23.3%。增强计算机断层扫描证实存在一个由腹主动脉发出的动脉瘤样动脉供血的肺隔离症。患者接受了供应动脉瘤的动脉的血管内弹簧圈栓塞，并在隔离症动脉的近端三分之一处植入了一个Amplatzer装置。随后的增强计算机断层扫描证实供应动脉瘤的异常动脉完全血栓形成，且肺隔离症无血供。在56个月的随访中，患者仍无症状，断层扫描显示隔离症缩小，异常动脉完全血栓形成。文中讨论了不同治疗方案所带来的挑战。
