Khamooshi Parnia, Vijayan Karthik, DiRico Michael, Mehta Hiren
Pulmonary and Critical Care Medicine, University of Florida, Gainesville, USA.
Cureus. 2025 Feb 26;17(2):e79685. doi: 10.7759/cureus.79685. eCollection 2025 Feb.
Aspergilloma is a common cause of hemoptysis and can result in significant morbidity and mortality in patients with structural lung disease. While surgical resection is the gold standard for treating aspergilloma, many patients are not suitable candidates for surgery. In this report, we explore the use of endobronchial valves (EBVs) as a non-surgical alternative for managing recurrent hemoptysis in a patient with interstitial lung disease (ILD) and a left upper lobe aspergilloma. Despite previous treatments, including antifungals and radiation, the patient experienced persistent hemoptysis and was not a candidate for either bronchial artery embolization or lobectomy. An EBV was implanted in the affected lung segment, resulting in the resolution of the hemoptysis without valve-related complications on the six-month follow-up. While the use of EBVs for hemoptysis management has been reported in a few cases, this is, to our knowledge, the first report in a patient with ILD. This approach presents a viable non-surgical alternative in complex cases where conventional treatments have proven ineffective or are not feasible.
曲霉菌球是咯血的常见原因，可导致结构性肺病患者出现严重的发病率和死亡率。虽然手术切除是治疗曲霉菌球的金标准，但许多患者并不适合手术。在本报告中，我们探讨了使用支气管内瓣膜（EBV）作为一种非手术替代方法，用于治疗一名间质性肺病（ILD）合并左上叶曲霉菌球患者的复发性咯血。尽管此前进行了包括抗真菌药物和放疗在内的治疗，但该患者仍持续咯血，且不适合进行支气管动脉栓塞或肺叶切除术。在受影响的肺段植入了一个EBV，在六个月的随访中，咯血得到缓解，且未出现与瓣膜相关的并发症。虽然已有少数病例报道使用EBV治疗咯血，但据我们所知，这是首例在ILD患者中的报道。在传统治疗已被证明无效或不可行的复杂病例中，这种方法提供了一种可行的非手术替代方案。
