Role of indocyanine green in anomalous arterial supply to the normal dorsobasal segment of the lung

Abstract

Background Anomalous systemic arterial supply to normal basal lung segments is a rare congenital malformation, in which aberrant arteries arising from the systemic circulation flow into the basal segment of the lung and return to normal pulmonary veins without abnormal bronchial branching. It presents a left-to-right shunt, resulting in volume overload of the pulmonary circulation, and consequently, pulmonary hypertension. Therefore, nearly all cases require surgery. Herein, we present a case, in which indocyanine green was used to demarcate the lung segment perfused by an anomalous systemic artery. Case presentation A 15-year-old boy was diagnosed with an anomalous artery originating from the celiac artery and supplying the right dorsobasal lung segment (S10). Via three-port video-assisted thoracoscopic surgery, the anomalous artery was ligated and processed with an auto-stapler. Indocyanine green was injected intravenously to identify the tissue perfused by the anomalous artery, and the lung was resected. Conclusions With anomalous systemic arterial supply to normal basal lung segments, indocyanine green can be particularly helpful in identifying the boundaries of the perfused area. Then, the affected tissue can be resected by thoracoscopic surgery.

Arterial Embolization and Cone-Beam Computed Tomography-Guided Lung Resection for Anomalous Systemic Arterial Blood Supply to Normal Lung: Two Case Reports

“…[14][15][16] In one recently reported case, this technique was employed to detect a specific-artery-perfused area. 17) We detected the area perfused by the aberrant artery, which showed us as an area of disrupted blood flow, using ICG navigation after ligation of the aberrant artery using a surgical endoscope (Image 1, D-light system; Karl Storz Endoscope, Japan K.K., Tokyo, Japan).…”

Anomalous systemic arterial supply to the basal segment of the lung presenting with haemoptysis in the third trimester of pregnancy

“…Traditionally management involved surgical resection of the aberrant artery and lung resection, however transarterial embolisation has recently been utilised for certain cases. [8][9][10] There has been a single case report of ABLL 11 and few reports of the related condition of PS presenting for the first time in pregnancy. 12,13 We describe a case of ABLL presenting with haemoptysis in the third trimester.…”

“…Traditionally management involved surgical resection of the aberrant artery and lung resection, however transarterial embolisation has recently been utilised for certain cases. 8–10…”