title: Transcatheter embolization for hemoptysis associated with anomalous systemic artery in a patient with scimitar syndrome.
abstract: BACKGROUND
  Scimitar syndrome can present with a wide clinical spectrum of symptoms either early in the neonatal period or later in life.
  
  
  METHODS
  We report a case of a 62-year-old woman with anomalous systemic arterial supply to the basal lung with scimitar syndrome presenting as recurrent hemoptysis. Bronchoscopy revealed normal major bronchial branches without bronchial atresia, indicating that sequestration of the lung was not confirmed. The anomalous drainage of the scimitar vein was to the inferior vena cava, and an anomalous artery from the aorta supplied the right basal lung. There were no findings of pulmonary hypertension and arteriovenous malformation such as an anomalous artery to the scimitar vein. The distal portions of anomalous arteries were embolized using gelatin sponge particles and the proximal portion was embolized using fibered detachable coils. Although a small pulmonary infarction was observed as a complication, the patie nt has not experienced any subsequence recurrence of the hemoptysis during a follow-up period of 6 months.
  
  
  RESULTS
  Deformities of the blood vessels and the lungs are frequently complex in scimitar syndrome. Although patients treated with surgical repair of this disorder may be at higher risk than those treated less invasively, we believe that transcatheter embolization was a useful strategy for the treatment of the anomalous systemic arterial supply to the basal lung, particularly in this patient with scimitar syndrome.
  
  
  CONCLUSIONS
  Hemoptysis in a patient with scimitar syndrome associated with anomalous systemic arterial supply to the basal lung was successfully treated with transcatheter arterial embolization. However, it might be better to avoid the use of gelatin sponge particles in patients with a similar anomaly without pulmonary artery distribution because of the possibility of causing severe pulmonary infarction.
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567 Japan.
authors: Hideaki
authors: H
authors: Yamakawa
authors: Department of Radiology, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
authors: Kanichiro
authors: K
authors: Shimizu
authors: Department of Radiology, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
authors: Kenkichi
authors: K
authors: Michimoto
authors: Department of Radiology, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
authors: Yoshihiko
authors: Y
authors: Kameoka
authors: Division of Cardiology, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
authors: Ryeonshi
authors: R
authors: Kang
authors: Division of Cardiology, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, Chiba, Japan.
authors: Jun
authors: J
authors: Yoshida
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567 Japan.
authors: Masami
authors: M
authors: Yamada
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567 Japan.
authors: Masahiro
authors: M
authors: Yoshida
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567 Japan.
authors: Takeo
authors: T
authors: Ishikawa
authors: Division of Respiratory Medicine, Department of Internal Medicine, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567 Japan.
authors: Masamichi
authors: M
authors: Takagi
authors: Division of Respiratory Medicine, Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan.
authors: Kazuyoshi
authors: K
authors: Kuwano
keywords: Anomalous systemic arterial supply to the basal lung; Hemoptysis; Scimitar syndrome; Transcatheter embolization