Erratic coil migration in the bronchus after bronchial artery embolization

Ishikawa, Hirotaka; Omachi, Naoki; Ryuge, Misaki; Takafuji, Jun; Hara, Masahiko

doi:10.1002/rcr2.478

Cited by 9 publications

(12 citation statements)

References 5 publications

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“…Although embolization is 80-90% effective at controlling acute hemoptysis from all causes, the three-year recurrence of hemoptysis is nearly 45% [10]. Complications of coil implantation such as erosion and migration have been reported years after intervention, and migration into the airway is uncommon but has been described [11][12][13]. A literature review in 2013 evaluated 107 reports of PAA treatment in patients with BD and evaluated medical, endovascular, and surgical management in a total of 173 patients.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Artery-Tracheal Fistula After Coil Implantation for Behcet’s Disease

Hansen

Dyke

2020

Cureus

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Behcet’s disease (BD) is a rare autoimmune disorder that results in diffuse full-thickness vasculitis. Pulmonary artery aneurysms (PAAs) and hemoptysis are known complications of this disease process, with high morbidity and mortality for affected patients. Although medical, endovascular, and surgical treatment strategies have all been described in the literature, there are little data to describe the long-term outcomes of these various treatment modalities and there continues to be a lack of clearly defined algorithms for the management of these patients. We report a case of PAA in the setting of BD who was treated over the course of many years with medical therapy and coil embolization but ultimately failed treatment, sustained a complication of coil erosion and migration into the trachea twice, and required surgical lobectomy for definitive management. We discuss an algorithm for the management of patients with BD who have PAAs.

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Section: Discussionmentioning

confidence: 99%

Pulmonary Artery-Tracheal Fistula After Coil Implantation for Behcet’s Disease

Hansen

Dyke

2020

Cureus

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“…Since the coil was placed in the vessel, fistula formation by coil migration may induce fatal massive hemoptysis [ 12 ], air embolism [ 13 ] or retrograde infection to the blood stream. It has also been reported that the metallic coil as a foreign body induced cough and hoarseness [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…There is a previous report on bronchoscopic removal of migrated coil after bronchial artery embolization. The authors carefully split the coil by a loop cutter and removed by forceps [ 14 ]. We did not choose transbronchial coil removal under intubation because of the possibility of massive hemoptysis.…”

Section: Discussionmentioning

confidence: 99%

Migrated coil expectorated 12 years after embolization of pulmonary arteriovenous malformation, due probably to abscess formation around the coil

Konno-Yamamoto

Yamamoto

Suzuki

et al. 2020

Respiratory Medicine Case Reports

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Pulmonary arteriovenous malformations (PAVMs) are rare vascular structures providing direct capillary-free communications between pulmonary arteries and veins. Embolotherapy is indicated as a front-line therapy. We report an unusual long-term complication of coil embolization for a 44-year-old woman with hereditary hemorrhagic telangiectasia (HHT) who had repeatedly undergone the procedures for her PAVMs. She expectorated the coil which had been placed 12 years earlier and migrated to the bronchus according to the chest radiogram and bronchoscopy. Histology of the resected lung segment suggested the cavity communicating with the bronchus was the consequence of abscess formation around the coils. Even after technically successful embolization to PAVMs, long term follow-up should be necessary paying attention to the symptoms and imaging to avoid massive hemoptysis and subsequent emergency surgery.

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“…Despite having a low rate of complications, coil embolization for pulmonary artery disorders do pose some risks such as recanalization, coil migration, coils misplaced in undesirable sites, damage to the vessel wall and delayed bacterial contamination of the thrombus and pulmonary artery. Erratic coil migration into the bronchial tree or other areas of the lung parenchyma is a very rare complication, with only a few cases having been described in the literature [ 3 – 5 ]. Erosion into the bronchi results in cough, expectoration, haemoptysis, and hoarseness [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…Erratic coil migration into the bronchial tree or other areas of the lung parenchyma is a very rare complication, with only a few cases having been described in the literature [ 3 – 5 ]. Erosion into the bronchi results in cough, expectoration, haemoptysis, and hoarseness [ 3 ]. The fistulisation into the pulmonary artery can result in air embolism or life-threatening haemoptysis [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Late endovascular coil migration following traumatic pulmonary artery pseudoaneurysm embolization: case report

Budacan

Patel

Foss

et al. 2022

J Cardiothorac Surg

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Background Percutaneous vascular interventions are performed for the treatment of haemoptysis and involve embolization of bronchial arteries, pulmonary arteries and pulmonary arteriovenous malformations. There are isolated reports of embolization of pseudoaneurysms forming in the pulmonary vasculature. The migration of components of the coils used in the embolization of vascular pulmonary pathologies is rare. Case presentation A 46-year-old man presented to the emergency department with cough, haemoptysis, and expectoration of lengths of metal wire. He had an episode of coughing out a wire about a year prior to his admission to our hospital, which he attributed to be present in the can of coke he had consumed at that time and did not report it to the doctors. His past medical history was significant for stab injury to the right chest 17 years ago, for which he underwent right thoracotomy and exploration for bleeding. Injury to the lung parenchyma was noted and repair was performed by suturing the defect. Post operatively the CT scan demonstrated development of pulmonary artery pseudoaneurysm. We report a case of a patient expectorating coils 17 years after embolization of this traumatic pulmonary artery pseudoaneurysm. Radiological imaging demonstrated coils in the perihilar area of the lung parenchyma and in the tracheobronchial lumen. Operative intervention was used to remove the coils. Conclusions Although percutaneous catheter based vascular interventions have emerged as safe and effective procedures, the long-term complications such as coil migration, recanalization and need for further embolization ought to be considered and patients need to be counselled and followed-up accordingly. To the best of our knowledge, this is the first case of migrated coil post embolization of post-traumatic pulmonary artery pseudoaneurysm. Ultimately, the management of endobronchial coil migration post embolization, be it surgical or bronchoscopic, should be decided on a case-by-case basis, considering the patient’s symptoms and the risk fatal complications.

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Erratic coil migration in the bronchus after bronchial artery embolization

Cited by 9 publications

References 5 publications

Pulmonary Artery-Tracheal Fistula After Coil Implantation for Behcet’s Disease

Pulmonary Artery-Tracheal Fistula After Coil Implantation for Behcet’s Disease

Migrated coil expectorated 12 years after embolization of pulmonary arteriovenous malformation, due probably to abscess formation around the coil

Late endovascular coil migration following traumatic pulmonary artery pseudoaneurysm embolization: case report

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