Stent implantation for malignant pulmonary artery stenosis in a metastasizing non-small cell bronchial carcinoma.
A 58-year-old patient with recently diagnosed non-small cell bronchial carcinoma was referred to us with increasing shortness of breath and orthopnea by her family practitioner. To exclude the possibility of a pulmonary embolism, contrast medium-enhanced angio-CT of the thorax was performed. This showed a large mediastinal tumor, which, on the one hand, infiltrated and occluded the left upper lobe bronchus and, on the other, constricted the left pulmonary artery over a considerable part of its length. In view of the palliative situation and massively increasing dyspnea, balloon dilatation of the obstructed left pulmonary artery followed by stent placement was performed. This resulted in an immediate improvement of the symptoms. The originally strongly oxygen-dependent and heavily dyspneic patient could be relieved of the external supply of oxygen and was able to sleep normally without additional medication within 24 h. The patient was able ambulate freely within 2 days, with a markedly improved quality of life.
Department of Radiology, Kantonsspital Winterthur, Brauerstr. 15, 8401 Winterthur, Czech Republic. andreas.gutzeit@ksw.ch
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D000792:Angiography; D001984:Bronchial Neoplasms / Q000473:pathology*; D018287:Carcinoma, Large Cell / Q000473:pathology*; D003251:Constriction, Pathologic; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D015641:Radiography, Interventional; D015607:Stents; D014057:Tomography, X-Ray Computed