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Wynne DM, Jefferson XD. Coil Embolization of an Inferior Phrenic Artery-to-Pulmonary Artery Fistula. J Vasc Interv Radiol 2022; 33:736-738. [PMID: 35314369 DOI: 10.1016/j.jvir.2022.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/18/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- David M Wynne
- Section of Interventional Radiology, Department of Radiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
| | - Xavier D Jefferson
- Section of Interventional Radiology, Department of Radiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030
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Kawakado K, Yabuki T, Nishi T, Nakanishi M, Makimoto G, Tamura T, Kuyama S. Successful transcatheter arterial embolization of asymptomatic aneurysm associated with left inferior phrenic artery-to-left pulmonary artery fistula: A case report. Respir Med Case Rep 2021; 33:101444. [PMID: 34401284 PMCID: PMC8349102 DOI: 10.1016/j.rmcr.2021.101444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/12/2021] [Accepted: 05/27/2021] [Indexed: 11/25/2022] Open
Abstract
Cases of inferior phrenic artery-to-pulmonary artery fistulas and those complicated by massive hemoptysis have been rarely reported. A 38-year-old man presented to our hospital with a chief complaint of coughing. Computed tomography (CT) revealed a nodule in the left lower lobe, and contrast-enhanced CT showed inflow of contrast medium into the nodule. CT angiography detected an aneurysm associated with a left inferior phrenic artery-to-left pulmonary artery fistula. Transcatheter arterial embolization (TAE) was performed to prevent hemoptysis. Hemoptysis did not occur during the 2-year follow-up. We report a rare case of asymptomatic aneurysm associated with a left inferior phrenic artery-to-left pulmonary artery fistula, which was successfully treated using TAE to prevent hemoptysis.
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Affiliation(s)
- Keita Kawakado
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
- Corresponding author. Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iwakuni-City, Yamaguchi, 740-8510, Japan.
| | - Takayuki Yabuki
- Department of Radiology, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
| | - Tatsuya Nishi
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
| | - Masamoto Nakanishi
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
| | - Go Makimoto
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
| | - Tomoki Tamura
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
| | - Shoichi Kuyama
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, 1-1-1 Atago-machi, Iawkuni-City, Yamaguchi, 740-8510, Japan
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Long-life relationships always bring trouble. Pulmonology 2020; 26:53-54. [DOI: 10.1016/j.pulmoe.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 06/02/2019] [Accepted: 07/02/2019] [Indexed: 11/22/2022] Open
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Livingston D, Grove M, Grage R, McKinney JM. Systemic Artery-to-Pulmonary Artery Fistula Mimics Pulmonary Embolus. J Clin Imaging Sci 2019; 9:41. [PMID: 31583179 PMCID: PMC6759949 DOI: 10.25259/jcis_54_2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 12/03/2022] Open
Abstract
Systemic artery-to-pulmonary artery fistula (SA-PAF) is a rare phenomenon that can resemble a filling defect on computed tomography angiography (CTA). SA-PAF can be due to congenital or acquired etiologies and can alter the hemodynamics of the pulmonary circulation, with the most serious reported complication being hemoptysis, requiring embolization. We describe a case of an unusual SA-PAF between the right inferior phrenic artery and the right lower lobe pulmonary artery that mimicked an unprovoked pulmonary embolus (PE) on standard CTA in a patient with cardiomyopathy. This SA-PAF was interpreted on CTA as PE due to the presence of a filling defect, revealing that not all filling defects are PE. SA-PAF should always be considered when the clinical context or the imaging findings are atypical, specifically with an isolated filling defect visualized in the inferior lower lobe pulmonary artery. The false-positive PE was the result of mixing of systemic non-opacified blood with opacified pulmonary arterial blood.
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Affiliation(s)
- David Livingston
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Matthew Grove
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Rolf Grage
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - J Mark McKinney
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
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