Retrospective review of the diagnosis and treatment of pulmonary sequestration in 28 patients: surgery or endovascular techniques?

Zhang, Shixin; Wang, Haidong; Yang, Kuo‐Chung; Cheng, Wei; Wu, Wei

doi:10.21037/jtd.2017.10.145

Cited by 26 publications

(29 citation statements)

References 19 publications

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“…Some studies drew conclusions that endovascular technique was considered for patients when pulmonary lesions were small-sized (<3 cm). [13] Due to a retrospective study and a limited number of cases, we cannot conclude the specific size of the sequestration as a basis for treatment option in our study. Prospective studies and large sample are needed to establish criteria for treatment options based on lesion size.…”

Section: Discussionmentioning

confidence: 91%

Endovascular treatment of pulmonary sequestration with thoracic endograft

Chen

Liu²,

Shao³

et al. 2019

Medicine

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Introduction: Pulmonary sequestration (PS) is a rare congenital lung malformation. The classical treatment of the disease has been conventional surgery with resection of abnormal parenchyma. Recently, the endovascular embolization has been proposed for the treatment of this disease. Here we present 2 cases of PS successfully treated with thoracic endograft. Patient concerns: Two patients with abnormal consolidation in the left lower lobe were admitted in our hospital. Diagnosis: Chest computed tomography angiography (CTA) showed abnormal consolidation in the left lower lobe, which received systemic blood supply from the descending aorta in both patients. So the diagnosis of PS was confirmed. Interventions: Endovascular treatment with thoracic endograft was successfully performed. Outcomes: The patients recovered well and were completely free of symptoms. And the CTA follow-up showed the abnormal pulmonary parenchyma shrunk significantly. Conclusions: Endovascular treatment with thoracic endograft is a promising treatment option for PS.

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Section: Discussionmentioning

confidence: 91%

Endovascular treatment of pulmonary sequestration with thoracic endograft

Chen

Liu²,

Shao³

et al. 2019

Medicine

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“…DSA is the gold standard for the diagnosis of PS. Enhanced CT and CTA can clearly show aberrant feeding arteries, identify the initial site and shape of aberrant feeding arteries, and signi cantly reduce the risk of bleeding in the intraoperative blood vessels in the abnormal body circulation caused by insu cient preoperative evaluation [7,8]. For suspected patients with PS, enhanced CT and CTA can effectively reduce misdiagnosis and missed diagnosis of PS.…”

Section: Discussionmentioning

confidence: 99%

“…It is controversial that whether patients with PS should receive surgical intervention because data regarding the surgery outcome, long-term clinical course and quality of life are rare [8][9][10][11].Patients with different symptoms of PS should receive different treatment strategies. It is generally accepted that patients diagnosed with ILS whether asymptomatic or not and patients diagnosed with ELS with symptom should receive surgical intervention [10].Non-operative management is better suited for asymptomatic ELS.…”

Section: Discussionmentioning

confidence: 99%

Aberrant Feeding Artery Mutilation Treatment of Pulmonary Sequestration: A Case Report

Liu

Han

Wang

et al. 2020

Preprint

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Background: Pulmonary sequestration (PS) is a rare congenital pulmonary pulmonary malformation. In this study, we reported a case of PS treated with aberrant feeding artery mutilation in our center.Case Presentation: A 29 –year-old female patient presented to our center in March 2020 due to repeated hemoptysis for more than 15 years, she received CTA examination which showed an aberrant feeding artery from the thoracic aorta into the left lower lobe of the lung and was therefore diagnosed with left lower lung pulmonary sequestration. Given that she complained with no infectious symptoms, she was treated with thoracoscopic feeding artery mutilation in June 2020 . She and experienced an uneventful postoperative course and was discharged 2 days postoperatively. On the postoperative follow-up of 4 months, thise patient’s physical condition was excellent and free of any symptoms such as hemoptysis or cough.Conclusion: Surgery is still the first choose for the treatment of PS. When pulmonary lesion is small-sized,for PS patients with non-infectious symptoms, aberrant feeding artery mutilation can be attempted as an alternative to intravascular technology for the treatment of PS. Future large studies are required to further verify its long-term efficacy and scope of application.

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“…9 Since then, it has had reported success in both the pediatric and adult setting. 8,10 The benefits of endovascular interventions with embolization and/or stent graft occlusion of the pulmonary vascular supply include shorter length of stay, decreased invasiveness, and decreased bleeding risk associated with thoracotomy or thoracoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Thoracic Stent Graft Accompanied by Coil Embolization for Pulmonary Sequestration

Wilder

Minasyan

2019

Innovations�(Phila)

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Thoracic stent graft plus coil embolization is a promising option for management of pulmonary sequestrations. Here we present the case of a 43-year-old male with chronic recurrent chest pain and hemoptysis that was incidentally identified as having a Pryce Type I pulmonary sequestration. The patient had a known history of gastritis, alcohol abuse, chronic leg and back pain, and was incidentally found to have an anomalous artery from the descending thoracic aorta to the left lower lobe. Due to recurrent hemoptysis and refractory back pain with no other identifiable etiology, he was consented for coil embolization and thoracic endovascular aortic repair. In conjunction with interventional radiology, coil embolization of the aberrant thoracic artery was performed under fluoroscopic guidance with good graft coverage of the aberrant artery with an endovascular graft. The patient’s postoperative recovery was uneventful and he reported a decrease in his chest pain. Repeat imaging including chest X-ray and CT angiography were performed prior to discharge. CT angiography demonstrated good positioning of the coils as well as the stent graft. The patient was discharged on postoperative day 1. Surgical intervention with ligation of the anomalous vessel has historically been the primary intervention for patients with Pryce Type I sequestrations, and it has yielded satisfactory results. However, thoracic stent graft in addition to coil embolization is a minimally invasive management option that should be considered as the first line of treatment because of the minimal physiologic burden on the patient and quicker recovery as compared to traditional thoracotomy.

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Retrospective review of the diagnosis and treatment of pulmonary sequestration in 28 patients: surgery or endovascular techniques?

Cited by 26 publications

References 19 publications

Endovascular treatment of pulmonary sequestration with thoracic endograft

Endovascular treatment of pulmonary sequestration with thoracic endograft

Aberrant Feeding Artery Mutilation Treatment of Pulmonary Sequestration: A Case Report

Thoracic Stent Graft Accompanied by Coil Embolization for Pulmonary Sequestration

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