Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study.

Autor: Liu M; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, No 2, East Yinghua Road, 100029, Beijing, China., Liu J; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, No 2, East Yinghua Road, 100029, Beijing, China., Yu W; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Gao X; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Chen S; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Qin W; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Zhu Z; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Li C; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China.; Institute of Pulmonary Vascular Diseases, Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China., Li F; Department of Pulmonary and Critical Care Medicine, Affiliated Hospital of Jianghan University, No.168 Hongkong Road, 430000, Wuhan, Hubei, China. 80670519@qq.com., Zhai Z; National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, Chinese Academy of Medical Sciences, China-Japan Friendship Hospital, No 2, East Yinghua Road, 100029, Beijing, China. zhaizhenguo2011@126.com.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2024 Aug 28; Vol. 24 (1), pp. 417. Date of Electronic Publication: 2024 Aug 28.
DOI: 10.1186/s12890-024-03225-0
Abstrakt: Background: Hemoptysis resulting from rupture of the pulmonary artery pseudoaneurysm (PAP) is massive and fatal, while factor contributing to the rupture of pseudoaneurysm remains elusive. This study aimed to elucidate the clinical and radiological features of PAP and identify the risk factors associated with rupture.
Methods: Patients who developed hemoptysis with PAP were collected from January 2019 to December 2022 retrospectively. Clinical data of the demographic characteristics, radiological findings, treatment strategies, and prognosis were collected. A comparative analysis was performed on the characteristics in the ruptured and non-ruptured cases.
Results: A total of 58 PAPs were identified in the 50 patients. The most common causes were infection (86%) and cancer (8%). The PAPs were located predominantly in the upper lobes of both lungs, and 57 (99.3%) were distributed in the segmental or subsegmental pulmonary arteries. The median diameter was 6.1(4.3-8.7) mm. A total of 29 PAPs were identified adjacent to pulmonary cavitations, with the median diameter of the cavity being 18.9 (12.4-34.8) mm. Rupture of pseudoaneurysm occurred in 21 cases (42%). Compared to unruptured group, the ruptured group had a significantly higher proportion of massive hemoptysis (57.1% vs. 6.9%, p < 0.001), larger pseudoaneurysm diameter (8.1 ± 3.2 mm vs. 6.0 ± 2.3 mm, p = 0.012), higher incidence of pulmonary cavitation (76.2% vs. 44.8%, p = 0.027), and larger cavitation diameters (32.9 ± 18.8 mm vs. 15.7 ± 8.4 mm, p = 0.005). The mean pulmonary artery pressure (mPAP) in the ruptured group was also significantly higher than that in the unruptured group [23.9 ± 7.4 mmHg vs. 19.2 ± 5.0 mmHg, p = 0.011]. Endovascular treatment was successfully performed in all 21 patients with ruptured PAP, of which the clinical success rate was 96.0%. Five patients experienced recurrent hemoptysis within one year.
Conclusions: Massive hemoptysis, pseudoaneurysm diameter, pulmonary cavitation, and elevated mPAP were the risk factors for rupture of pseudoaneurysm. Our findings facilitate early identification and timely intervention of PAP at high risk of rupture.
(© 2024. The Author(s).)
Databáze: MEDLINE
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