Preprocedural Planning with Prospectively Triggered Multidetector Row CT Angiography Prior to Bronchial Artery Embolization in Cystic Fibrosis Patients with Massive Hemoptysis

Hayes, Don; Winkler, Michael; Kirkby, Stephen; Capasso, Patrizio; Mansour, Heidi M.; Attili, Anil

doi:10.1007/s00408-011-9343-y

Cited by 14 publications

(4 citation statements)

References 19 publications

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“…Instead of aortography, precise analysis of dynamic CT images is useful in identifying individual anatomical variations ( 17 , 29 ). Vascular 3-D images effectively support selecting small branches arising from the aorta ( 30 ). Selective arterial contrast infusion CT is crucial in estimating individual arterial supply to the target lesions ( 11 , 26 , 27 ).…”

Section: Present Understanding On Arterial Management Of Lung Cancermentioning

confidence: 99%

Transarterial management of advance lung cancer

Hori¹,

Nakamura²,

Kennoki³

et al. 2021

Japanese Journal of Clinical Oncology

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Previous reports on transarterial treatment for lung cancer were reviewed. The bronchial arterial infusion therapy has a long history since 1964. Better local control with less doses of anti-neoplastic agents was warranted by trying transarterial administration to lung and mediastinal tumors. It is reported that both primary and metastatic tumors are fed by bronchial or other systemic arteries. The bronchial arterial embolization for hemoptysis has been introduced for clinical practice since 1973. Hemoptysis by not only benign but also malignant diseases has been well controlled by embolization. In recent decades, the technical elements for transarterial treatments have markedly improved. They make it possible to carry out precise procedures of selective catheter insertion to the tumor relating arteries. Current concepts of transarterial treatment, technical aspects and treatment outcomes are summarized. Tentative result from chemo-embolization for advanced lung cancer using recent catheter techniques was also described. It provides favorable local control and survival merits. It is considered that a population of lung cancer patients can benefit from transarterial management using small doses of anti-neoplastic agents, with less complications and less medical costs.

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Section: Present Understanding On Arterial Management Of Lung Cancermentioning

confidence: 99%

Transarterial management of advance lung cancer

Hori¹,

Nakamura²,

Kennoki³

et al. 2021

Japanese Journal of Clinical Oncology

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“…Reconstructive techniques such as two-dimensional maximum intensity projection (MIP), three-dimensional volumetric, and shaded surface display reformatted images can provide further information on the paths of culprit vessels and serve as a useful planning tool for BAE. Additionally, electrocardiographic synchronization during scanning increases spatial resolution and decreases artifact (53).…”

Section: Radiology and Ct Imagingmentioning

confidence: 99%

Management of life-threatening hemoptysis in the ICU

Charya¹,

Holden²,

Pickering³

2021

J Thorac Dis

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Life-threatening hemoptysis is commonly encountered in the ICU and its management can be challenging even for experienced clinicians. Depending on the etiology and severity, one can tailor the treatment modality and therapeutic intervention(s). The grading of severity of hemoptysis varies greatly in the literature; however, unlike hemorrhage in other scenarios, small amounts of blood can significantly impair oxygenation and ventilation leading to cardiovascular collapse. Importantly, the initial evaluation and management should focus on airway and hemodynamic stabilization along with maintenance of oxygenation and ventilation. In this review, we discuss commonly encountered etiologies, vascular anatomy, diagnostic evaluation, and therapeutic interventions. We examine the evolving trends in etiologies of life-threating hemoptysis over the years. The role of flexible and rigid bronchoscopy as both a diagnostic and therapeutic modality is explored, as well as the use and indications of several bronchoscopic techniques, such as topical hemostatic agents, endobronchial tamponade, and tranexamic acid (TXA). In addition, we assess the use of multi-row detector computed tomography as the initial rapid diagnostic method of choice and its use in planning for definitive treatment. The efficacy and long-term results of bronchial artery embolization (BAE) are evaluated, as well as indications for surgical intervention. Furthermore, the importance of a multidisciplinary approach is emphasized. The necessary interplay between intensivists, consultative services, and radiologists is described in detail and an algorithmic management strategy incorporating the above is outlined. Given the complexity in management of life-threatening hemoptysis, this paper aims to summarize the available diagnostic and therapeutic methods and provide a standardized approach for the management of patients with this often difficult to treat condition.

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“…With prospective ECG triggering the dose can be reduced to a mean 2.1 to 9.2 mSv, because in this mode scanning takes place only at defined intervals of the cardiac cycle; however, adequate preparation of the patient (heart rate <75 bpm) is necessary (28,29). The information gained from multislice computed tomography reduces the intervention time, radiation dose, and amount of contrast medium needed for subsequent bronchial artery embolization (30). Reconstruction should be carried out in the lung and soft-tissue window (5 mm) together with thin-slice reconstructions (1 mm) to find the openings of the bronchial arteries.…”

Section: Diagnosismentioning

confidence: 99%