Emergency endovascular management of pulmonary artery aneurysms and pseudoaneurysms for the treatment of massive haemoptysis.

INTRODUCTION

In this study we report the results of endovascular techniques for the management of pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAPS).

METHODS

Cases with massive haemoptysis due to PAA and/or PAPS that were managed by endovascular means were included in the study. Clinical history and procedure details were analysed. Primary endpoints were immediate technical success and re-intervention rate; secondary endpoints were survival rate and relapse of bleeding.

RESULTS

Among the 72 patients with massive haemoptysis who were treated in our department during an 8-year period, 6 patients with 6 lesions (2 PAA, 4 PAPS) fulfilled the inclusion criteria and were included in the study. The mean age was 46.5 years; mean lesion diameter was 12.7 mm (range 4-22 mm); underlying pathologies were vasculitis (n=2), erosion by necrotic tumour (n=1), previous lung surgery (n=1) and infectious disease (n=2). Four lesions were treated with coils, 1 with coils and a bare stent, and 1 with a covered stent. The technical success was 100%. Mean follow-up was 20.4 months. The re-intervention rate was 50%, but in only 16.6% was it related to the treated lesions. Survival rate was 66.6%. There were no major or minor complications.

CONCLUSION

Endovascular management offers a safe and effective solution for the emergency treatment of massive haemoptysis due to PAA and PAPS. A variety of endovascular devices may be used, according to the size and the anatomical location of the lesion.