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The Pulmonary and Bronchial Vessels, Pulmonary Vascular Abnormalities including Embolism, Pulmonary and Bronchial Angiography, and A/V Malformations.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Bronchial artery embolisation has also been used to control haemoptysis in some cases of bronchial neoplasm. A problem is that entering a tiny vessel with a minute catheter may provoke arterial spasm, and more than one attempt may be required.
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The supply of the lesion by the bronchial artery helps exclude pulmonary sequestration, which receives a systemic arterial supply. Similarly, this makes a diaphragmatic hernia, such as a Bochdalek hernia, unlikely. The question also states that the diaphragm is intact.
Pulmonary Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Charles S. Dela Cruz, Barbara Seaworth, Graham Bothamley
Bronchial artery embolization is the first mode of treatment where conservative measures fail to halt the hemoptysis.59 Cannulation of bronchial arteries is technically difficult and requires an experienced interventional radiologist.
Current pharmacological solutions for Behçet’s syndrome
Published in Expert Opinion on Pharmacotherapy, 2023
Yesim Ozguler, Sinem Nihal Esatoglu, Gulen Hatemi
Surgical interventions for venous thrombosis should be avoided due to the high rate of complications [84]. Lobectomy may be a rare option in patients with giant pulmonary artery aneurysms or those with massive hemoptysis [85]. Patients with pulmonary artery involvement may continue to experience hemoptysis episodes due to bronchial artery collaterals. Bronchial arterial embolization provided some success in controlling bleeding episodes in such cases [86]. However, severe complications such as pulmonary infarction and hemiparesis may occur. Endarterectomy has been tried for pulmonary artery involvement complicated by chronic thromboembolic pulmonary hypertension (CTEPH) in a case series of 9 BS patients [87]. Symptomatic improvement was obtained in 8 patients after a median follow-up of 29.4 months. Complications were hemoptysis and reversible bilateral vocal cord paralysis, which were observed in 2 patients. One patient died one month after surgery due to massive hemoptysis. It is imperative to ensure the lack of active inflammation before procedures for vascular involvement.
Proximal pulmonary artery embolization for recurrent hemoptysis after bronchial artery embolization
Published in Baylor University Medical Center Proceedings, 2021
Eric M. Swanson, Brandon Dickey, James Murray, Steven Ruiz
Recurrent hemoptysis occurs in approximately 20% of lung tumor patients, with a 3% incidence of death when hemoptysis is severe.1 Most hemoptysis (>90%) originates from the systemic arteries, with <10% originating from the pulmonary artery (PA).2 The underlying pathology contributing to hemoptysis in lung tumor patients is PA erosion secondary to necrotic tumor processes.3 Currently, bronchial artery embolization is the first-line interventional radiology treatment, with surgical management often used as the definitive treatment in surgical candidates.4 However, in 20% of patients, bleeding will persist after bronchial artery embolization and is associated with high mortality.5 In such cases, PA embolization is indicated to control persistent hemoptysis after bronchial artery embolization5 or in patients with PA erosion.6 Typically, only the segmental or distal branch of the PA contributing to the bleeding is embolized in an attempt to minimize the impact of embolization on pulmonary hemodynamics and maintain perfusion to as much of the lung parenchyma as possible. We present a case of a proximal PA embolization in a lung tumor patient with recurrent hemoptysis after bronchial artery embolization.
Ultra-central lung tumors: safety and efficacy of protracted stereotactic body radiotherapy
Published in Acta Oncologica, 2021
Joyce E. Lodeweges, Peter S. N. van Rossum, Marcia M. T. J Bartels, Anne S. R. van Lindert, Jacqueline Pomp, Max Peters, Joost J. C. Verhoeff
At the time of analysis, 45 patients (63%) had died. No information on the cause of death was available in 7 patients (10%) who survived 8–41 months. Of the latter, only one patient had manifested grade 3 toxicity. Seventeen patients (24%) died of the consequences of lung cancer and 11 patients (15%) as a result of causes unrelated to lung cancer. Possible treatment-related death was seen in 10 patients (14%) who all died of bronchopulmonary hemorrhage. This was observed at a median time after start of treatment of 11 months (range 8–21 months). All 10 patients had a PTV overlapping the main bronchus. Autopsy performed in 2 cases revealed a bronchial fistula between the main bronchus of the right lower lobe and the bronchial artery in one patient and a fistula between the main bronchus and the pulmonary artery in the other patient. These fistulas were both located in the high dose radiation area and due to ulceration and necrosis of the bronchus. One of 10 patients started with bevacizumab 2 months after SBRT for the lung because of synchronous diagnosed rectal cancer and developed fatal bronchopulmonary hemorrhage 6 months later. Among the patients with fatal bronchopulmonary hemorrhage, 6 patients (60%) used anticoagulant or antiplatelet drugs during SBRT, compared to 31 (50%) of 62 patients who did not die of bronchopulmonary hemorrhage (p = 0.736). Tumor histology was not significant associated with fatal bronchopulmonary hemorrhage (p = 0.094).