A case of delayed bleeding of the chest wall after VATS treated with transcatheter arterial embolization

TL;DR

An elderly woman experienced delayed chest wall bleeding after a minimally invasive lung cancer procedure, which was successfully treated with a catheter-based embolization technique.

Contribution

This case highlights the effectiveness of transcatheter arterial embolization in managing delayed post-VATS bleeding.

Findings

Delayed postoperative bleeding occurred 8 days after VATS for pleural biopsy.

Transcatheter arterial embolization successfully controlled the rebleeding and prevented recurrence.

Angiography revealed extravasation in the right lateral thoracic artery.

Abstract

We report a case of delayed bleeding after video-assisted thoracic surgery (VATS) that was successfully treated with transcatheter arterial embolization. An 81-year-old woman underwent a pleural biopsy via VATS for pleural dissemination of lung cancer. The postoperative course was good, but 8 days later she was hospitalized for swelling in the right axilla and was admitted to our hospital with a diagnosis of delayed postoperative hemorrhage. Gauze compression was performed, and the patient was discharged without exacerbation of hematoma. However, 4 days later, she was hospitalized for rapidly worsening swelling and pain. Chest computed tomography at the time of rebleeding showed an increase in the hematoma and extravasation in the peripheral right lateral thoracic artery. The patient was immediately treated with emergency angiography, and coil embolization was performed. After this treatment, the patient has done well and there has been no subsequent recurrence of bleeding.

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