A pulmonary artery was embolized in a patient with an occluded pulmonary vein to manage massive hemoptysis

TL;DR

A 64-year-old lung cancer patient with severe bleeding was successfully treated by blocking a pulmonary artery to achieve a functional lung lobe removal.

Contribution

A novel approach using pulmonary artery embolization to manage hemoptysis in a patient with occluded pulmonary vein due to lung cancer.

Findings

Embolization of the left superior pulmonary artery successfully stopped massive hemoptysis.

The patient remained stable with no recurrence of bleeding during a six-month follow-up.

This method achieved functional pulmonary lobectomy without the need for surgery.

Abstract

Stenosis and obliteration of the pulmonary vein can be developed by multiple diseases and might cause hemoptysis. Traditional therapy including surgical procedure and conservative treatments might be inappropriate choices to manage massive hemoptysis.

A 64-year-old man, diagnosed with advanced stage IVA lung squamous cell carcinoma, presented with dyspnea and recurrent, massive hemoptysis. An initial contrast-enhanced computed tomography revealed a giant tumor in the left lung hilus and occlusion of the left superior pulmonary vein. Despite immediate selective bronchial artery embolization and simultaneous embolization of an anomalous branch of the internal thoracic artery, the massive hemoptysis continued. Subsequently, embolization of the left superior pulmonary artery was performed, achieving functional pulmonary lobectomy, which successfully treated the hemoptysis without relapse during a six-month follow-up. The patient continues to undergo cancer therapy and remains stable.

This case successfully managed massive hemoptysis associated with lung cancer invasion into the pulmonary vein through functional pulmonary lobectomy via embolization of the corresponding pulmonary artery.

The online version contains supplementary material available at 10.1186/s12890-024-02968-0.

Figures