Gupta Jay, Patel Ronak, Patel Neal, Wynne David, Ghasemi-Rad Mohammad
Department of Student Affairs, Baylor College of Medicine, Houston, TX, USA.
Department of radiology, section of interventional radiology, Baylor college of Medicine, Houston, TX, USA.
Radiol Case Rep. 2024 Aug 29;19(11):5370-5375. doi: 10.1016/j.radcr.2024.07.173. eCollection 2024 Nov.
Endovascular stenting of the pulmonary artery treats arterial stenosis from pulmonary hypertension, congenital heart defects, or post-transplant stricture. Patients with malignant extrinsic pulmonary arterial compression, secondary to large mediastinal or pulmonary masses, often present with dyspnea, hypoxemia, and right ventricular failure. Conventional therapies like surgery, chemotherapy, and radiation are often slow and fail to promptly resolve acute symptoms. Balloon angioplasty and stenting have been explored as a rapid treatment to alleviate symptoms of external pulmonary artery compression. Despite its potential, the adoption of this procedure is limited due to risks like stent misplacement, migration, cardiac arrhythmias, and arterial rupture. This paper presents 3 cases of pulmonary angiography and stenting performed for malignant extrinsic pulmonary artery compression. These cases aim to demonstrate the feasibility of pulmonary artery stenting, encouraging its consideration as a palliative option for symptomatic patients with this condition.
肺动脉血管内支架置入术用于治疗由肺动脉高压、先天性心脏缺陷或移植后狭窄引起的动脉狭窄。继发于大的纵隔或肺部肿块的恶性外部肺动脉压迫患者，常表现为呼吸困难、低氧血症和右心衰竭。手术、化疗和放疗等传统治疗方法往往起效缓慢，无法迅速缓解急性症状。球囊血管成形术和支架置入术已被探索作为缓解外部肺动脉压迫症状的快速治疗方法。尽管有其潜力，但由于存在支架误置、移位、心律失常和动脉破裂等风险，该手术的应用受到限制。本文介绍了3例因恶性外部肺动脉压迫而行肺血管造影和支架置入术的病例。这些病例旨在证明肺动脉支架置入术的可行性，鼓励将其作为有症状患者的姑息治疗选择加以考虑。
