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Labbé H, Bordeleau S, Drouin C, Archambault P. Myocardial Infarction as a Complication of Bronchial Artery Embolization. Cardiovasc Intervent Radiol 2016; 40:460-464. [PMID: 27864609 DOI: 10.1007/s00270-016-1508-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/09/2016] [Indexed: 11/28/2022]
Abstract
Bronchial artery embolization is now a common treatment for massive pulmonary hemoptysis if flexible bronchoscopy at the bedside failed to control the bleeding. Complications of this technique range from benign chest pain to devastating neurological impairments. We report the case of a 41-year-old man who developed an ST elevation myocardial infarction during bronchial artery embolization, presumably because of coronary embolism by injected particles. In this patient who had no previously known coronary artery disease, we retrospectively found a communication between the left bronchial artery and the circumflex coronary artery. This fistula was not visible on the initial angiographic view and likely opened because of the hemodynamic changes resulting from the embolization. This case advocates for careful search for bronchial-to-coronary arterial fistulas and the need for repeated angiographic views during embolization procedures.
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Affiliation(s)
- Hugo Labbé
- Department of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4211, Québec, QC, G1V 0A6, Canada. .,CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada. .,Direction de l'enseignement, L'Hôtel-Dieu de Lévis, Local 2801, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada.
| | - Simon Bordeleau
- Department of Emergency Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4617, Québec, QC, G1V 0A6, Canada.,CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Christine Drouin
- Department of Anesthesiology and Critical Care Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4853, Québec, QC, G1V 0A6, Canada.,CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada
| | - Patrick Archambault
- Department of Emergency Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050 Avenue de la Médecine, Local 4617, Québec, QC, G1V 0A6, Canada.,CISSS de Chaudière-Appalaches, L'Hôtel-Dieu de Lévis, 143 Rue Wolfe, Lévis, QC, G6V 3Z1, Canada
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Hantous-Zannad S, Zidi A, Néji H, Attia M, Baccouche I, Ben Miled-M'rad K. [The role of imaging in thoracic tuberculosis]. REVUE DE PNEUMOLOGIE CLINIQUE 2015; 71:93-109. [PMID: 24874403 DOI: 10.1016/j.pneumo.2014.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/03/2014] [Accepted: 02/05/2014] [Indexed: 06/03/2023]
Abstract
Tuberculosis is an infectious disease mostly due to Mycobacterium tuberculosis. It is frequent in developing countries and its incidence is rising in developed countries. Lungs are the most involved organs of the chest but other structures can be affected. Imaging is fundamental in the management of the disease. Confirmation of diagnosis can be made only by bacteriologic and/or histologic exams. The first approach of diagnosis is based on clinical symptoms and chest X-ray signs. Radiologic signs depend on patient's age, his immune status and his previous contact with M. tuberculosis. Conventional chest X-ray remains the first-line exam to realize. It can suggest the diagnosis on the appearance and location of the lesions. CT scan is recommended for the positive diagnosis in case of discrepancy between clinical and radiographic signs, as for the diagnosis of parenchymal, vascular, lymph nodes, pleural, parietal or mediastinal complications. It is also essential for the evaluation of parenchyma sequelae. MRI and PET-scan have limited indications. The purpose of this article is to illustrate different radiological forms of chest tuberculosis, its sequelae and complications and to highlight the role of each imaging technique in the patient's management.
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Affiliation(s)
- S Hantous-Zannad
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie.
| | - A Zidi
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie
| | - H Néji
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie
| | - M Attia
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie
| | - I Baccouche
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie
| | - K Ben Miled-M'rad
- Service d'imagerie médicale, hôpital Abderrahmane Mami, Ariana, Tunisie
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