Medical pneumonectomy: interventional bronchoscopic and endovascular management of massive hemoptysis due to pulmonary artery pseudoaneurysm, a consequence of endobronchial brachytherapy.
Endobronchial brachytherapy serves as an excellent adjunct to standard external beam radiation therapy. The high dose of local radiation is still used to manage airway obstructions at some institutions, despite the well-known risks of airway fistulae to the esophagus or cardiovascular structures. A less reported complication is the development of a pulmonary artery pseudoaneurysm into the mainstem bronchi. The formation of an arterial pseudoaneurysm can lead to massive hemoptysis, which often is fatal. We present a case of massive hemoptysis due to this complication of brachytherapy managed entirely through bronchoscopic and endovascular techniques.
Chawla
Mohit
M
Section of Interventional Pulmonology and Bronchoscopy, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Henry Ford Hospital, Detroit, MI. Electronic address: chawlam1@mskcc.org.
Getzen
Todd
T
Division of Interventional Radiology, Department of Radiology, Henry Ford Hospital, Detroit, MI.
Simoff
Michael J
MJ
Section of Interventional Pulmonology and Bronchoscopy, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Henry Ford Hospital, Detroit, MI.
D017541:Aneurysm, False / Q000150:complications / Q000209:etiology* / Q000628:therapy*; D001918:Brachytherapy / Q000009:adverse effects*; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy; D004621:Embolization, Therapeutic; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage; D006469:Hemoptysis / Q000209:etiology* / Q000628:therapy*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D007322:Instillation, Drug; D007442:Intubation, Intratracheal; D007828:Laryngoscopy; D008175:Lung Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011859:Radiography; D015642:Radiology, Interventional; D015607:Stents
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics