A Stepwise Embolization Strategy for a Bronchial Arterial Aneurysm: Proximal Coil and Distal Glue with the Optional Use of a Microballoon Occlusion System
A Stepwise Embolization Strategy for a Bronchial Arterial Aneurysm: Proximal Coil and Distal Glue with the Optional Use of a Microballoon Occlusion System
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DOI：
10.1007/s00270-018-1969-1
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发表时间：
2018-08-01
影响因子：
2.9
通讯作者：
Hasebe, Terumitsu
中科院分区：
文献类型：
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作者：
Mine, Takahiko;Matsumoto, Tomohiro;Hasebe, Terumitsu
本研究旨在证明支气管动脉瘤（BAAs）的经导管栓塞策略，在近端病变使用弹簧圈，在远端病变使用胶（2-氰基丙烯酸正丁酯[NBCA]）栓塞，使用或不使用微球囊闭塞导管。支气管血管造影显示开口附近有纵隔BAA，伴有远端分支扩张，伴或不伴肺内BAA。进行了分步手术。首先，根据解剖学和局部血流动力学条件，使用或不使用微球囊导管，用胶水栓塞肺内分支。第二，纵隔BAA用可脱性弹簧圈紧密填塞，所有患者肺内异常分支的胶栓塞成功控制了咯血; 10支动脉中有5支使用了微球囊导管。弹簧圈在纵隔BAA内的体积栓塞率范围为28 - 59%，随访期间未观察到弹簧圈压实或再通迹象，顺序使用胶（有或无微球囊闭塞系统）和可脱弹簧圈的逐步栓塞程序可能代表治疗复杂BAA.Level 4的可能血管内策略：病例系列。
This study aimed to demonstrate a transcatheter embolization strategy for bronchial artery aneurysms (BAAs) using coils for the proximal lesion and glue (n-butyl-2-cyanoacrylate [NBCA]) embolization for the distal lesion with or without the use of a microballoon occlusion catheter.Five patients with BAAs presenting with hemoptysis were enrolled in this study. A bronchial angiogram indicated a mediastinal BAA near the orifice, accompanied by dilated distal branches with or without intrapulmonary BAA. A stepwise procedure was performed. First, the intrapulmonary branches were embolized with glue, with or without the use of a microballoon catheter depending upon the anatomical and local flow hemodynamic conditions. Second, the mediastinal BAA was tightly packed with detachable coils.Glue embolization of intrapulmonary abnormal branches successfully controlled hemoptysis in all patients; microballoon catheters were used in five of the 10 arteries. The volume embolization ratio of coils within the mediastinal BAA ranged from 28 to 59%, and neither coil compaction nor signs of recanalization were observed during follow-up.The stepwise embolization procedure with the sequential use of glue (with or without a microballoon occlusion system) and detachable coils may represent a possible endovascular strategy for the treatment of complex BAAs.Level 4: Case Series.