Computed tomography angiography for presence of systemic-to-pulmonary artery shunt in transpleural systemic arterial supply

Zhang, Yifan; Zhao, Qiong; Huang, Rui

doi:10.1016/j.ejrad.2020.109060

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Visualizing SPSs and considering possible outcomes before the BAE procedure seem to be key issues. CTA has the potential to show radiographic indications of SPS in the transpleural systemic arterial supply [ 27 ]. Clinically, because CT scans are still suboptimal for identifying the existence and dynamics of SPS, these shunts are mainly identified by angiography.…”

Section: Discussionmentioning

confidence: 99%

Does the presence of systemic artery–pulmonary circulation shunt during bronchial arterial embolization increase the recurrence of noncancer-related hemoptysis? A retrospective cohort study

Yan

Liu

et al. 2023

Respir Res

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Background The presence of systemic artery–pulmonary circulation shunt (SPS) during the bronchial arterial embolization (BAE) procedure, has been inferred to be a potential risk factor for recurrence. The aim of this study is to reveal the impact of SPS on the recurrence of noncancer-related hemoptysis after BAE. Methods In this study, 134 patients with SPS (SPS-present group) and 192 patients without SPS (SPS-absent group) who underwent BAE for noncancer-related hemoptysis from January 2015 to December 2020 were compared. Four different Cox proportional hazards regression models were used to clarify the impact of SPSs on hemoptysis recurrence after BAE. Results During the median follow-up time of 39.8 months, recurrence occurred in 75 (23.0%) patients, including 51 (38.1%) in the SPS-present group and 24 (12.5%) in the SPS-absent group. The 1-month, 1-year, 2-year, 3-year and 5-year hemoptysis-free survival rates in the SPS-present and SPS-absent groups were 91.8%, 79.7%, 70.6%, 62.3%, and 52.6% and 97.9%, 94.7%, 89.0%, 87.1%, and 82.3%, respectively (P < 0.001). The adjusted hazard ratios of SPSs in the four models were 3.37 [95% confidence intervals (CI), 2.07–5.47, P < 0.001 in model 1], 1.96 (95% CI, 1.11–3.49, P = 0.021 in model 2), 2.29 (95% CI, 1.34–3.92, P = 0.002 in model 3), and 2.39 (95% CI, 1.44–3.97, P = 0.001 in model 4). Conclusions The presence of SPS during BAE increases the recurrence probability of noncancer-related hemoptysis after BAE.

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Section: Discussionmentioning

confidence: 99%

Does the presence of systemic artery–pulmonary circulation shunt during bronchial arterial embolization increase the recurrence of noncancer-related hemoptysis? A retrospective cohort study

Yan

Liu

et al. 2023

Respir Res

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“…CT imaging is crucial in the diagnosis of SPAS. It helps identify characteristic findings such as pleural thickness, neovascular vessels in the chest wall, aneurysms within the lung parenchyma, and filling defects in PA in the pulmonary-arterial phase [ 4 , 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Systemic-to-pulmonary artery sunt (SPAS) is a rare condition that can occur as a result of congenital heart disease or chronic pulmonary inflammation, leading to a life-threatening hemoptysis [ 1 – 3 ]. Computed tomography (CT) scan findings such as pleural thickness and enhancing vascular structures are suggestive of systemic arterial supply [ 4 ]. In patients with SPAS, there is regurgitation from the systemic arteries to the pulmonary arteries, as observed on contrast-enhanced CT scans.…”

Section: Introductionmentioning

confidence: 99%

“…Transcatheter arterial embolization (TAE) has emerged as an important treatment modality for patients with SPAS. However, the optimal management for patients with SPAS remains uncertain, as TAE alone may provide temporary relief and subsequent recanalization or development of collateral neovascularization sometimes occur [ 4 ]. In this unique case report, we present a novel approach to treat SPAS consisting of TAE of the systemic artery followed by a lung segmentectomy.…”

Section: Introductionmentioning

confidence: 99%

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Systemic-to-pulmonary artery shunt treated with transcatheter arterial embolization and subsequent lung segmentectomy

Notsuda,

Tomiyama,

Onodera

et al. 2023

Egypt Heart J

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Background Systemic-to-pulmonary artery shunt (SPAS) is a rare condition that can occur as a result of congenital heart disease or chronic pulmonary inflammation, occasionally leading to life-threatening hemoptysis. Computed tomography (CT) imaging is crucial in the diagnosis of SPAS, and the optimal management approach for SPAS remains uncertain. This case report presents a novel approach to the treatment of SPAS, consisting of transcatheter arterial embolization of the systemic artery followed by lung segmentectomy. Case presentation A 42-year-old man with abnormal chest findings was referred to us and a diagnosis of SPAS was established based on the CT findings showing a blood flow regurgitation from the dilated left 4th intercostal artery to the Lt. A6. The patient was asymptomatic but we decided to treat him to prevent a risk of future hemoptysis. Transcatheter arterial embolization (TAE) of systemic arteries followed by S6 segmentectomy was successfully performed with minimal blood loss and complete removal of the dilated intra-pulmonary blood vessels. Histological analysis confirmed the diagnosis of SPAS. Conclusion We reported a case of SPAS, who was successfully treated with the combination of TAE and subsequent segmentectomy. The blood loss during surgery was minimal and this strategy appeared to minimize future recanalization and hemoptysis. Further studies and long-term follow-up of SPAS patients are required to establish standardized management guidelines for this rare condition.

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Transpleural Systemic Artery to Pulmonary Artery Fistulas: Doppler Ultrasound Findings

Gorospe,

Gómez-Bermejo,

Palomera-Rico

2024

Archivos de Bronconeumología

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Computed tomography angiography for presence of systemic-to-pulmonary artery shunt in transpleural systemic arterial supply

Cited by 4 publications

References 21 publications

Does the presence of systemic artery–pulmonary circulation shunt during bronchial arterial embolization increase the recurrence of noncancer-related hemoptysis? A retrospective cohort study

Does the presence of systemic artery–pulmonary circulation shunt during bronchial arterial embolization increase the recurrence of noncancer-related hemoptysis? A retrospective cohort study

Systemic-to-pulmonary artery shunt treated with transcatheter arterial embolization and subsequent lung segmentectomy

Transpleural Systemic Artery to Pulmonary Artery Fistulas: Doppler Ultrasound Findings

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