ABSTRACT
UNLABELLED: BACKGROUND; Hemoptysis can be an acute medical emergency, which can be localized angiographically and controlled by therapeutic intervention. PURPOSE: To evaluate the effectiveness and safety of bronchial artery embolization, and including follow-up in patients with hemoptysis. MATERIAL AND METHODS: Thirty-five vascular interventions were performed in 28 patients (nine women and 19 men, mean age 42 years, age range 20-82 years) treated for hemoptysis between January 1998 and October 2008. Underlying diseases were cystic fibrosis (n = 9), lung cancer (n = 6), chronic inflammatory disease (n = 4), bronchiectasis (n = 3), chronic obstructive pulmonary disease (n = 2), and other (n = 4). Bronchial artery embolization was performed using particles. Patients were followed up for a median of 23 months (range 1 month to 8 years). RESULTS: Bronchial artery embolization was technically successful in all patients (bleeding halted within 24 hours). Recurrent bleeding occurred in four patients with cystic fibrosis (14%) at one, 16, 19 and 48 months, respectively. Within this subset, multirecurrence bleeding occurred in one patient with cystic fibrosis. Cumulative patient survival rate was 74% at eight years. No patient died due to hemoptysis but due to underlying disease. CONCLUSION: Bronchial artery embolization was highly effective in patients with hemoptysis. It may help to avoid surgery in patients who are poor candidates for surgery. Should hemoptysis recur in these patients, repeated embolization can be performed.
Subject(s)
Bronchial Arteries/diagnostic imaging , Embolization, Therapeutic/methods , Hemoptysis/therapy , Adult , Aged , Aged, 80 and over , Bronchiectasis/complications , Chronic Disease , Cystic Fibrosis/complications , Female , Follow-Up Studies , Hemoptysis/complications , Humans , Inflammation/complications , Lung Neoplasms/complications , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Radiography , Treatment Outcome , Young AdultSubject(s)
Angioplasty, Balloon/adverse effects , Arm/blood supply , Early Ambulation/adverse effects , Femoral Artery , Femoral Neck Fractures/etiology , Hemostatic Techniques/instrumentation , Accidental Falls , Aged , Angiography/methods , Angioplasty, Balloon/methods , Arthroplasty, Replacement, Hip/methods , Female , Femoral Neck Fractures/diagnostic imaging , Femoral Neck Fractures/surgery , Follow-Up Studies , Humans , Ischemia/diagnostic imaging , Ischemia/therapy , Paresthesia/complications , Punctures , Risk AssessmentABSTRACT
Equivocal initial CT-based staging in 2 patients with hilar bronchial neoplasms was reassessed with retrospective ECG-gated Multislice-CT and optimized examination parameters prior to definition of treatment. An initially suspected irresectable T4 tumor with mediastinal infiltration was downstaged to T2 in one case, while tumor infiltration into the left atrium could be confirmed in the other case. In doubtful conditions, ECG-gated multislice CT with optimized examination parameters may be helpful for refined staging in patients with hilar bronchial neoplasms, thus possibly influencing treatment strategies.
Subject(s)
Carcinoma, Bronchogenic/pathology , Carcinoma, Small Cell/pathology , Carcinoma, Squamous Cell/pathology , Cardiac-Gated Imaging Techniques , Image Processing, Computer-Assisted/methods , Lung Neoplasms/pathology , Tomography, Spiral Computed/methods , Aged , Bronchi/pathology , Carcinoma, Bronchogenic/surgery , Carcinoma, Small Cell/surgery , Carcinoma, Squamous Cell/surgery , Contrast Media , Female , Heart Ventricles/pathology , Humans , Iopamidol/analogs & derivatives , Lung/pathology , Lung Neoplasms/surgery , Male , Mediastinum/pathology , Middle Aged , Neoplasm Invasiveness , Neoplastic Cells, Circulating , Prognosis , Sensitivity and SpecificityABSTRACT
This report describes a technique for advanced endoluminal reconstruction of complex bifurcational arterial obstructions located within the mesenteric arcade deploying applications from percutaneous transluminal coronary artery angioplasty. A patient was treated for persistent mesenteric ischemia during prolonged recovery after initial small bowel resection due to acute mesenteric ischemia. Following endovascular reconstruction of a complex arterial obstruction within the mesenteric arcade, ischemic symptoms subsided quickly and the patient recovered well. According to the literature, this seems to be the first case where such distal reconstruction of the mesenteric arcade has successfully been achieved percutaneously.
Subject(s)
Angioplasty/instrumentation , Intestines/blood supply , Ischemia/etiology , Mesenteric Vascular Occlusion/diagnostic imaging , Mesenteric Vascular Occlusion/surgery , Stents , Aged , Angioplasty/methods , Follow-Up Studies , Humans , Ischemia/diagnostic imaging , Ischemia/surgery , Male , Mesenteric Arteries , Mesenteric Vascular Occlusion/complications , Prosthesis Design , Radiography, Interventional , Risk Assessment , Severity of Illness Index , Treatment Outcome , Vascular Patency/physiologyABSTRACT
Percutaneous computed tomographic (CT) fluoroscopy-guided biopsy was performed to evaluate an intracardiac tumor located within the left atrium of a 72-year-old woman. Postinterventional follow-up was unproblematic and free of complications. Histopathologic examination revealed a high-grade cardiac sarcoma, and the patient underwent consecutive resection and radiation therapy. In general, percutaneous puncture of the heart must be considered hazardous. Under certain conditions (eg, broad-based tumor, advanced luminal mass, myocardial and/or pericardial infiltration), however, percutaneous CT-guided biopsy may be an appropriate alternative to transluminal catheter biopsy for the minimally invasive investigation of cardiac tumors.
