title: Permanent cortical blindness after bronchial artery embolization.
abstract: A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.
authors.affiliation: Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Colette S
authors.initials: CS
authors.lastname: van Doorn
authors.affiliation: Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. d.w.deboo@amc.uva.nl.
authors.forename: Diederick W
authors.initials: DW
authors.lastname: De Boo
authors.affiliation: Department of Pulmonology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: Els J M
authors.initials: EJM
authors.lastname: Weersink
authors.affiliation: Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Otto M
authors.initials: OM
authors.lastname: van Delden
authors.affiliation: Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Jim A
authors.initials: JA
authors.lastname: Reekers
authors.affiliation: Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Krijn P
authors.initials: KP
authors.lastname: van Lienden
mesh_terms: D000328:Adult; D019575:Blindness, Cortical / Q000000981:diagnostic imaging / Q000209:etiology*; D001981:Bronchial Arteries / Q000002:abnormalities / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003550:Cystic Fibrosis / Q000150:complications*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000009:adverse effects; D006469:Hemoptysis / Q000209:etiology / Q000628:therapy; D006801:Humans; D011856:Radiographic Image Enhancement / Q000379:methods; D013348:Subclavian Artery / Q000002:abnormalities / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media