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Claudinot A, Douane F, Morla O, Perret C, Neveu M, Thouveny F, Bouvier A, Hureaux J, Le Guen A, Jouan J, Heautot JF, Larralde A, Cerasuolo D, Bergot E, Fohlen A, Pelage JP. Pulmonary Artery Embolization in the Management of Hemoptysis Related to Lung Tumors. J Pers Med 2023; 13:1597. [PMID: 38003912 PMCID: PMC10672290 DOI: 10.3390/jpm13111597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
(1) Background: Bronchial artery embolization has been shown to be effective in the management of neoplastic hemoptysis. However, knowledge of pulmonary artery embolization is lacking. The aim of this study was to evaluate the safety and efficacy of pulmonary artery embolization in patients presenting with hemoptysis related to lung tumors. (2) Methods: This retrospective study reviewed all consecutive patients with cancer and at least one episode of hemoptysis that required pulmonary artery embolization from December 2008 to December 2020. The endpoints of the study were technical success, clinical success, recurrence of hemoptysis and complications. (3) Results: A total of 92 patients were treated with pulmonary artery embolization (63.1 years ± 9.9; 70 men). Most patients had stage III or IV advanced disease. Pulmonary artery embolization was technically successful in 82 (89%) patients and clinically successful in 77 (84%) patients. Recurrence occurred in 49% of patients. Infectious complications occurred in 15 patients (16%). The 30-day mortality rate was 31%. At 3 years, the survival rate was 3.6%. Tumor size, tumor cavitation and necrosis and pulmonary artery pseudoaneurysm were significantly associated with recurrence and higher mortality. (4) Conclusions: Pulmonary artery embolization is an effective treatment to initially control hemoptysis in patients with lung carcinoma, but the recurrence rate remains high and overall survival remains poor.
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Affiliation(s)
- Amandine Claudinot
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
| | - Frédéric Douane
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Olivier Morla
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Christophe Perret
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Marine Neveu
- Department of Radiology, CHU de Nantes, 44000 Nantes, France; (F.D.); (O.M.); (C.P.); (M.N.)
| | - Francine Thouveny
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - Antoine Bouvier
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - José Hureaux
- Department of Radiology, CHU d’Angers, 49933 Angers, France; (F.T.); (A.B.); (J.H.)
| | - Arnaud Le Guen
- Department of Radiology, Centre Hospitalier Bretagne Atlantique, 56000 Vannes, France; (A.L.G.); (J.J.)
| | - Jérémy Jouan
- Department of Radiology, Centre Hospitalier Bretagne Atlantique, 56000 Vannes, France; (A.L.G.); (J.J.)
| | | | - Antoine Larralde
- Department of Radiology, CHU de Rennes, 35000 Rennes, France; (J.-F.H.); (A.L.)
| | - Damiano Cerasuolo
- Department of Biostatistics and Clinical Research, CHU de Caen, 14000 Caen, France
| | - Emmanuel Bergot
- Department of Pulmonology and Respiratory Disease, CHU de Caen, 14000 Caen, France;
| | - Audrey Fohlen
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
- Normandy University, UNICAEN, CEA, CNRS, ISTCT-CERVOxy, 14000 Caen, France
| | - Jean-Pierre Pelage
- Department of Radiology, CHU de Caen, 14000 Caen, France; (A.F.); (J.-P.P.)
- Normandy University, UNICAEN, CEA, CNRS, ISTCT-CERVOxy, 14000 Caen, France
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Veiga IB, Hahn K, Wenker C, Wyss F, Mühlethaler K, Posthaus H, Jan Janzen. Pulmonary Artery Aneurysm in a Greater Flamingo (Phoenicopterus roseus) Associated with Aspergillus fumigatus Infection. J Comp Pathol 2021; 184:19-23. [PMID: 33894873 DOI: 10.1016/j.jcpa.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/13/2020] [Accepted: 01/16/2021] [Indexed: 12/01/2022]
Abstract
We report necropsy findings in a captive 60-year-old female greater flamingo (Phoenicopterus roseus) that died suddenly following rupture of a pulmonary artery aneurysm. Histologically, there was focally extensive, intramural granulomatous inflammation with intralesional fungal hyphae, and adjacent severe mixed-cell inflammation and acute haemorrhage at the rupture site. Aspergillus fumigatus was identified as the aetiological agent following DNA PCR amplification and sequencing from paraffin-embedded pulmonary artery tissue sections. The most likely explanation is that this lesion was a consequence of haematogenous spread, secondary to mycotic pneumonia or aerosacculitis, following aspiration of A. fumigatus conidiospores. However, no further fungal-related lesions were observed on gross or histopathological examination.
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Affiliation(s)
- Inês B Veiga
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Kerstin Hahn
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | | | - Konrad Mühlethaler
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Horst Posthaus
- Institute of Animal Pathology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Benhassen LL, Højsgaard A, Allan Terp K, de Paoli FV. Surgical approach to a mycotic aneurysm of the pulmonary artery presenting with hemoptysis - A case report and a review of the literature. Int J Surg Case Rep 2018; 50:92-96. [PMID: 30092541 PMCID: PMC6086216 DOI: 10.1016/j.ijscr.2018.07.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/16/2018] [Accepted: 07/24/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mycotic aneurysms of the pulmonary arteries are very rare and have high mortality. Risk groups are intravenous drug users and patients with congenital heart disorders. The surgical approach varies due to a limited number of reported cases. PRESENTATION OF CASE We present a case of a mycotic aneurysm of the right pulmonary artery in a 56-year old man presenting with recurrent pneumonias, weight loss and hemoptysis. DISCUSSION There is often a diagnostic delay because of non-specific symptoms mimicking more common disorders. Treatment strategies include conservative management, surgery and endovascular treatment. CONCLUSION This report demonstrates a rare case of aneurysm of the pulmonary artery presenting with hemoptysis. For rapidly progressing proximal aneurysms of the pulmonary arteries, the midline surgical approach is recommended.
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Affiliation(s)
- Leila Louise Benhassen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark.
| | - Anette Højsgaard
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
| | - Kim Allan Terp
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark
| | - Frank Vincenzo de Paoli
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle-Juul Jensens Boulevard 99, DK-8200, Aarhus N, Denmark; Department of Biomedicine, Aarhus University, Vennelyst Boulevard 4, DK-8000, Aarhus C, Denmark
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