Posterior circulation infarction after bronchial artery embolization.

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Acta radiologica open Pub Date : 2023-04-01 DOI:10.1177/20584601231168968
Lei Yu, Xionghui Li, Feng Lin, Tuer Wan, Zhiwei Cao
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Abstract

Bronchial artery embolization is minimally invasive, has a low complication rate, and achieves good hemorrhage control. It is the first-line treatment in hemoptysis patients whom medications are ineffective. Cerebral infarction is a rare complication of bronchial artery embolization, with posterior circulation infarcts being the most common. Possible mechanisms include a neurotoxic reaction to the contrast medium used, bronchial artery-pulmonary shunt, embolus formation, fistula formation between the bronchial artery and the cerebral artery, and so on. To the best of our knowledge, there have been relatively few reports regarding posterior circulation infarcts after BAE, including 14 cases shown in Table 1. 11 patients recovered well after medical treatment, while the other patients did not survive. We report a case of a patient with a large posterior circulation infarct post bronchial artery embolization who developed severe neurological symptoms and died after 3 months of medication. Conclusion: Posterior circulation infarction is a rare but severe complication of bronchial artery embolization, and measures should be taken to prevent its occurrence.

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支气管动脉栓塞后后循环梗塞。
支气管动脉栓塞术微创,并发症发生率低,能很好地控制出血。对于药物无效的咯血患者,它是一线治疗方法。脑梗死是支气管动脉栓塞的罕见并发症,后循环梗死是最常见的。可能的机制包括对造影剂的神经毒性反应,支气管动脉-肺分流,栓子形成,支气管动脉和脑动脉之间形成瘘管,等等。据我们所知,关于BAE后循环梗死的报道相对较少,包括表1所示的14例。11例患者经治疗恢复良好,其余患者死亡。我们报告了一例支气管动脉栓塞后出现大面积后循环梗死的患者,他出现了严重的神经系统症状,并在药物治疗3个月后死亡。结论:后循环梗塞是支气管动脉栓塞术后少见但严重的并发症,应采取预防措施。
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