Infarction of the left main-stem bronchus: a complication of bronchial artery embolization

Ivanick, M J; Thorwarth, William T.; Donohue, James F.; Mandell, Valerie S.; Delany, D; Jaques, Paul F.

doi:10.2214/ajr.141.3.535

Cited by 61 publications

(27 citation statements)

References 8 publications

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“…In histological specimens, the presence of NBCA-Lp was fulfilled as a cast, whereas GSPs were dispersed in the vessels. These results support the clinical findings that the frequency of recurrent hemoptysis was 23%-33% after embolization with GSPs [8,22] and/or PVA particles, and 10%-16.6% after NBCA-Lp embolization [8,14] . Histological examination of the lungs revealed no pulmonary infarction.…”

supporting

confidence: 89%

“…The occurrence of paraplegia is considered to be related to the anatomical anastomosis between the bronchial artery and the anterior spinal artery. Furthermore, Ivanick et al [8] have reported that BAE using ethanol with high occlusion potency causes bronchial wall necrosis.…”

Section: Introductionmentioning

confidence: 99%

“…Ivanick et al [8] have reported that embolic materials < 350 µm should not be used because Pump [23] has reported two types bronchopulmonary anastomoses of 24-48 µm and 72-325 µm. Ikoma et al [24] have reported that histological examination of the lungs following BAE with NBCA-Lp in humans revealed no damage to the bronchial wall but they did not clarify the safety basis.…”

mentioning

confidence: 99%

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Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model

Tanaka

Kawai²,

Sato³

et al. 2012

WJR

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AIM:To compare the efficacy and safety of bronchial artery embolization (BAE) with n-butyl cyanoacrylate (NBCA) and gelatin sponge particles (GSPs). METHODS:Six healthy female swine were divided into two groups to be treated with BAE using NBCAlipiodol (NBCA-Lp) and using GSPs. The occlusive durability, the presence of embolic materials, the response of the vessel wall, and damage to the bronchial wall and pulmonary parenchyma were compared. RESULTS:No animals experienced any major complication. Two days later, no recanalization of the bronchial artery was observed in the NBCA-Lp group, while partial recanalization was seen in the GSP group. Embolic materials were not found in the pulmonary artery or pulmonary vein. NBCA-Lp was present as a bubblelike space in bronchial branch arteries of 127-1240 µm, and GSPs as reticular amorphous substance of 107-853 µm. These arteries were in the adventitia outside the bronchial cartilage but not in the fine vessels inside the bronchial cartilage. No damage to the bronchial wall and pulmonary parenchyma was found in either group. Red cell thrombus, stripping of endothelial cells, and infiltration of inflammatory cells was observed in vessels embolized with NBCA-Lp or GSP. CONCLUSION:NBCA embolization is more potent than GSP with regard to bronchial artery occlusion, and both materials were present in bronchial branch arteries ≥ 100 µm diameter.

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supporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model

Tanaka

Kawai²,

Sato³

et al. 2012

WJR

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“…Brinson et al [4]have recently reported their group’s success with BAE, and demonstrated the efficacy of BAE was 75% after a single attempt. Multiple complications from BAE have been reported including: development of systemic collateral vessels [4], transverse myelitis [12], superior vena cava obstruction [13], bronchoesophageal fistulas [14, 15], systemic emboli [16], recurrent hemorrhage [4, 10], bronchial necrosis [17], and paralysis [16, 18]. Systemic collateral vessels arising from a spinal artery are a frequent finding [19], which significantly increases the risk of paralysis from the procedure.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Recurrent Severe Hemoptysis in Cystic Fibrosis with Tranexamic Acid

Graff

2001

Respiration

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Major hemoptysis is a potentially life-threatening complication of cystic fibrosis (CF) lung disease. Bronchial artery embolization (BAE) along with treatment of a CF pulmonary exacerbation has become the most widely used therapeutic approach for major hemoptysis in CF. However, BAE has been associated with severe complications, especially when bronchial artery to spinal artery anastomoses are present. This case study describes the successful treatment of major hemoptysis in CF with tranexamic acid, in an individual in whom 12 previous BAE procedures had been performed and further procedures were contraindicated secondary to bronchial artery to spinal artery collaterals. Recurrence of the hemoptysis occurred after attempts had been made to withdraw the tranexamic acid. Tranexamic acid was resumed with resolution of the hemoptysis, and the therapy has been used continuously for 13 months without any complications.

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“…Legsúlyosabb szövődmény a gerincvelői ischaemia (1,4-6,5%), amely a medullaris ágak fi gyelmetlen embolisatiójának eredménye [21,22]. Igen ritka szövődményként leírtak bronchialis necrosist, bronchooesophagealis fi stulát [23,24]. Előfordult kérgi vakság is, amelynek oka feltehetően nem szándékos embolisatio lehetett a bronchialis artériás rendszer és az arteria vertebralis vagy egy pulmonalis véna közötti fi stulán keresztül [25,26].…”

Section: Szövődményekunclassified

Akut és szubakut klinikai állapotok radiológiai intervenciója: fókuszban a nem vascularis intervenciók és a haemoptysis kezelése

Nemes

Doros

2015

Orvosi Hetilap

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Az intervenciós radiológia módszerei gyors, egyszerű és kevéssé megterhelő megoldásokat kínálnak akut és szubakut helyzetekben is. Nem vascularis intervenciók körébe tartoznak a folyadékgyülemek aspirációja, drenázsa, az epeúti intervenciók egy része, a percutan nephrostoma behelyezése és a bélpasszázs átmeneti helyreállítása is. Ebben az összefoglalóban a szerzők részletesebben foglalkoznak a szintén akutan kezelendő haemoptysis intervenciós radioló-giájával is. Az esetek jelentős részében a beavatkozások 12-24 órán belül elvégzendők, amelyhez ideális esetben a hét minden napján 24 órában szolgáltatást nyújtó, speciális tudással és felszereléssel rendelkező és megfelelően fi nanszí-rozott centrumok biztosítanak hátteret. A szakmák közötti konzultáció, együttműködés, a megfelelő indikációs konszenzus és a strukturált oktatás teszi igazán effektívvé az ilyen, még kialakításra váró centrumok működését. Orv. Hetil., 2015, 156(17), 687-695.Kulcsszavak: intervenciós radiológia, drenázs, biliaris intervenció, endourológia, gastrointestinalis stent, haemoptysis, embolisatio Acute and subacute clinical situations managed by interventional radiology: Focus on non-vascular interventions and treatment of hemoptysisInterventional radiology provides fast, straightforward and tolerable solutions for many medical problems including acute and subacute situations. Aspiration and drainage of fl uid collections, biliary and endourologic interventions and gastrointestinal interventions are parts of non-vascular interventions. In addition, the authors discuss in detail interventional radiological treatment options in patients with hemoptysis. In acute cases interventions must be performed within 12-24 hours. For background, an everyday 24 hours service should be provided with well-trained personnel, high quality equipment and devices, and a reasonable fi nancial reimbursement should be included, too. Multidisciplinary teamwork, consultations, consensus in indications and structured education should make these centers function most effectively. Rövidítések ABE = arteria bronchialis embolisatio; AVM = arteriovenosus malformatio; BA = bronchialis artéria; DSA = digitális szubtrakciós angiográfi a; ERCP = endoszkópos retrográd cholangiopancreatographia; MDCTA = multidetektoros CT-angiográfi a; nBCA = n-butil-cianoakrilát; PTC = percutan transhepaticus cholangiographia; PTD = percutan transhepaticus drenázs; PVA = polivinil-alkohol

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Infarction of the left main-stem bronchus: a complication of bronchial artery embolization

Cited by 61 publications

References 8 publications

Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model

Safety of bronchial arterial embolization with n-butyl cyanoacrylate in a swine model

Treatment of Recurrent Severe Hemoptysis in Cystic Fibrosis with Tranexamic Acid

Akut és szubakut klinikai állapotok radiológiai intervenciója: fókuszban a nem vascularis intervenciók és a haemoptysis kezelése

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