Thorac Cardiovasc Surg 2010; 58(4): 229-231
DOI: 10.1055/s-0029-1240977
Special Report

© Georg Thieme Verlag KG Stuttgart · New York

Is Transcatheter Rescue Management of a Pulmonary Artery Bronchial Fistula Justified?

C. M. Bhamidipati1 , L. J. Kohman1
  • 1Department of Surgery, State University of New York Upstate Medical University, Syracuse, New York, USA
Further Information

Publication History

received Nov. 10, 2009

Publication Date:
31 May 2010 (online)

Abstract

Endobronchial brachytherapy and interventional bronchology have changed the management of stage 3A (T4N0M0) non-small cell lung carcinoma. We discuss the case of a female patient who developed massive hemoptysis due to a fistula between the left pulmonary artery and stented left main bronchus. Although transcatheter management of the fistula was initially successful, the patient outcome secondary to coronary insult was poor. We present our management dilemma to highlight the need for careful consideration when selecting patients with heavily irradiated chests for endobronchial stenting.

References

  • 1 Villanueva A G, Lo T C, Beamis Jr J F. Endobronchial brachytherapy.  Clin Chest Med. 1995;  16 (3) 445-454
  • 2 Miller K L, Shafman T D, Anscher M S et al. Bronchial stenosis: an underreported complication of high-dose external beam radiotherapy for lung cancer?.  Int J Radiat Oncol Biol Phys. 2005;  61 (1) 64-69
  • 3 Carvalho H de A, Goncalves S L, Pedreira Jr W, Gregorio M G, de Castro I, Aisen S. Irradiated volume and the risk of fatal hemoptysis in patients submitted to high dose-rate endobronchial brachytherapy.  Lung Cancer. 2007;  55 (3) 319-327
  • 4 Hruz R, Hugli R, Keller D, Tamm M. [80-year-old patient with acute hemoptysis. Bronchopulmonary arterio-arterial fistula].  Praxis (Bern 1994). 2007;  96 (3) 73-75
  • 5 Chawla M, Getzen T, Simoff M J. Medical pneumonectomy: interventional bronchoscopic and endovascular management of massive hemoptysis due to pulmonary artery pseudoaneurysm, a consequence of endobronchial brachytherapy.  Chest. 2009;  135 (5) 1355-1358

Dr. Castigliano M. Bhamidipati

Department of Surgery
State University of New York Upstate Medical University
8140 University Hospital

750 East Adams Street

Syracuse, NY 13210

United States

Phone: + 1 20 72 29 16 60

Fax: + 1 70 25 43 46 56

Email: bhamidic@upstate.edu

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