1/215. Endovascular stent graft repair of aortopulmonary fistula.Two patients who had aortopulmonary fistula of postoperative origin with hemoptysis underwent successful repair by means of an endovascular stent graft procedure. One patient had undergone repeated thoracotomies two times, and the other one time to repair anastomotic aneurysms of the descending aorta after surgery for Takayasu's arteritis. A self-expanding stainless steel stent covered with a Dacron graft was inserted into the lesion through the external iliac or femoral artery. The patients recovered well, with no signs of infection or recurrent hemoptysis 8 months after the procedure. Endovascular stent grafting may be a therapeutic option for treating patients with aortopulmonary fistula.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/215. Aorto--bronchial fistula resulting from an accidental fall one year earlier.A 75-year-old woman presented with massive haemoptysis 12 months after tripping over her shopping trolley. CT scanning and transoesophageal echocardiography demonstrated a traumatic false aneurysm which was confirmed at surgery to be partially ruptured. Aortobronchial fistula is an unusual cause of massive haemoptysis. It should be considered particularly in patients known to have abnormalities of the thoracic aorta.- - - - - - - - - - ranking = 0.0012675159469721keywords = trauma (Clic here for more details about this article) |
3/215. Munchausen's syndrome. A case of factitious hemoptysis.Factitious hemoptysis is the bleeding type of Munchausen's syndrome, rarely reported in the literature (only seventeen cases). After a careful and detailed literature review, the authors report the case of a 22-year-old working-woman, with a history of asthma, Mediterranean anaemia and recurrent hemoptysis, who was admitted several times to the cardiovascular and Respiratory Sciences Department in the Carlo Forlanini Hospital in 1994 for an asthmatic attack and wheeziness at rest. During the admissions the patient underwent laboratory tests (such as the examination of sputum specimens, urinalysis, tuberculin test, cold agglutinins and pneumotropic virus tests) and diagnostic studies (fiberoptic bronchoscopy with bronchoalveolar lavage, computerized tomography and radiography of the chest, bronchial arteriography, bronchography, perfusion and ventilation lung scan), because she continually presented with hemoptysis, in order to spot and discover the nature of the bleeding. Since such examinations failed (a few of them-namely fiberoptic bronchoscopies--were even performed when she was coughing up blood) and psychiatric consultations revealed the presence of psychologically traumatic events in the patient's history which could explain the psychopathic traits of her personality (in fact she was aggressive and unstable in interpersonal relations), a diagnosis of factitious hemoptysis in Munchausen's syndrome was made.- - - - - - - - - - ranking = 0.0012675159469721keywords = trauma (Clic here for more details about this article) |
4/215. Delayed massive hemoptysis after expandable bronchial stent placement.patients with lung cancer often develop airway obstruction that necessitates palliative bronchoscopic interventions. Expandable metal stents are increasingly used for this indication. We report a case of fatal massive hemoptysis that occurred 1 week after uneventful bronchial stent placement. Previous treatment with external-beam radiotherapy, brachytherapy, and photodynamic therapy probably contributed to pulmonary artery-bronchial fistulization in this patient. This complication should be kept in mind when considering expandable airway stent insertion in heavily pretreated lung cancer patients.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
5/215. Bronchial artery embolization for massive hemoptysis.Improved angiographic techniques have proved that therapeutic embolization is effective in controlling massive hemorrhage in selected sites of the gastrointestinal tract and central nervous system. We have controlled massive hemoptysis in five cases with use of our improved techniques and bronchial artery embolization. Because mortality due to massive hemoptysis in both benign and malignant disease is high, therapeutic bronchial artery embolization is the preferable approach in some cases.- - - - - - - - - - ranking = 6keywords = artery (Clic here for more details about this article) |
6/215. Bronchial aneurysms mimicking aortic aneurysms: endovascular treatment in two patients.Bronchial artery dilatation and aneurysm formation is a potential complication of local inflammation, especially in bronchiectasis. When the bronchial artery has an ectopic origin from the inferior segment of the aortic arch, aneurysms may mimick aortic aneurysms. Despite this particular location, endovascular treatment is possible. We report two such aneurysms that were successfully embolized with steel coils.- - - - - - - - - - ranking = 2keywords = artery (Clic here for more details about this article) |
7/215. Hughes-Stovin syndrome: a case report and review of the literature.A young man presented with prolonged pyrexia, recurrent optic neuritis, thrombophlebitis and bilateral pulmonary artery aneurysms with thrombus formation. The life-threatening hemoptysis necessitated mechanical ventilatory support and emergency left lower lobectomy. Systemic corticosteroids conferred clinical improvement and reduction of the remaining right pulmonary artery aneurysm. The patient eventually succumbed to sudden massive hemoptysis. This report underscores the unpredictable nature of this syndrome and emphasises the need for aggressive surgical intervention of pulmonary artery aneurysms in Hughes-Stovin syndrome.- - - - - - - - - - ranking = 3keywords = artery (Clic here for more details about this article) |
8/215. Fatal pulmonary haemorrhage during anaesthesia for bronchial artery embolization in cystic fibrosis.Three children with cystic fibrosis (CF) had significant pulmonary haemorrhage during anaesthetic induction prior to bronchial artery embolization (BAE). Haemorrhage was associated with rapid clinical deterioration and subsequent early death. We believe that the stresses associated with intermittent positive pressure ventilation (IPPV) were the most likely precipitant to rebleeding and that the inability to clear blood through coughing was also an important factor leading to deterioration. Intermittent positive pressure ventilation should be avoided when possible in children with CF with recent significant pulmonary haemorrhage.- - - - - - - - - - ranking = 5keywords = artery (Clic here for more details about this article) |
9/215. Management of aortobronchial fistula with an aortic stent-graft.Aortobronchial fistula presenting as massive hemoptysis is a rapidly fatal process that is extremely difficult to manage. We report a case in which endovascular occlusion of a fistula between a thoracic aortic pseudoaneurysm and lung was successfully managed by placement of an aortic endovascular stent-graft. Stent-grafting is a promising technique in managing complications of thoracic aneurysms and grafts.- - - - - - - - - - ranking = 0.70370915637938keywords = pseudoaneurysm (Clic here for more details about this article) |
10/215. Endovascular occlusion of a carotid pseudoaneurysm complicating deep neck space infection in a child. Case report.Pseudoaneurysm formation of the cervical internal carotid artery (ICA) is a rare, potentially lethal complication of deep neck space infection. This entity typically occurs following otolaryngological or upper respiratory tract infection. The pseudoaneurysm is heralded by a pulsatile neck mass, Homer's syndrome, lower cranial neuropathies, and/or hemorrhage that may be massive. The recommended treatment includes prompt arterial ligation. The authors present a case of pseudoaneurysm of the cervical ICA complicating a deep neck space infection. A parapharyngeal staphylococcus aureus abscess developed in a previously healthy 6-year-old girl after she experienced pharyngitis. The abscess was drained via an intraoral approach. On postoperative Day 3, the patient developed a pulsatile neck mass, lethargy, ipsilateral Horner's syndrome, and hemoptysis, which resulted in hemorrhagic shock. Treatment included emergency endovascular occlusion of the cervical ICA and postembolization antibiotic treatment for 6 weeks. The patient has made an uneventful recovery as of her 18-month follow-up evaluation. Conclusions drawn.from this experience and a review of the literature include the following: 1) mycotic pseudoaneurysms of the carotid arteries have a typical clinical presentation that should enable timely recognition; 2) these lesions occur more commonly in children than in adults; 3) angiography with a view to performing endovascular occlusion should be undertaken promptly; and 4) endovascular occlusion of the pseudoaneurysm is a viable treatment option.- - - - - - - - - - ranking = 6.8049765966926keywords = artery, pseudoaneurysm, carotid artery, carotid (Clic here for more details about this article) |
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