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Case Reports
. 2023 Aug 11:21:101964.
doi: 10.1016/j.jaccas.2023.101964. eCollection 2023 Sep 6.

Coil Embolization as a Life-Saving Treatment for Pulmonary Artery Perforation Secondary to Large-Bore Catheterization

Joji Varghese  1 , Bailey Ann Estes  1 , Ashlyn Augustine  2 , Sukrita Menon  3 , Theresa Varghese  4 , Grady Yoder  1
Affiliations
Case Reports

Coil Embolization as a Life-Saving Treatment for Pulmonary Artery Perforation Secondary to Large-Bore Catheterization

Joji Varghese et al. JACC Case Rep. .

Abstract

We present a case of left pulmonary artery perforation during mechanical thrombectomy for treatment of pulmonary embolism. The patient's condition became hemodynamically unstable, with massive hemoptysis requiring intubation and multiple vasopressor agents. Prompt balloon tamponade and 0.035-mm coil embolization halted the extravasation. Coil embolization can be a lifesaving treatment for large vessel perforations. (Level of Difficulty: Intermediate.).

Keywords: coil embolization; large-bore catheter; perforation; pulmonary embolism; thrombectomy.

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Conflict of interest statement

Dr Varghese has served as a consultant for Shockwave Medical. Ms Estes has served as a consultant for Shockwave Medical. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Pulmonary Artery CTA Computed tomography angiography of the pulmonary trunk demonstrating large saddle embolus of the main, right, and left pulmonary trunk.
Figure 2
Figure 2
Pulmonary Angiography (A) Angiography of the right pulmonary artery with filling defect in the upper, middle, and lower lobes. (B) Angiography of the left pulmonary artery with filling defect in the upper, middle and lower lobes.
Figure 3
Figure 3
Pulmonary Artery Thrombectomy Results of mechanical thrombectomy from the right and left main pulmonary arteries.
Figure 4
Figure 4
Pulmonary Perforation Angiography of the left pulmonary artery demonstrating perforation of the mid branch and extravasation of contrast material in the extravascular space.
Figure 5
Figure 5
Post Coil Coil embolization of the left pulmonary artery with successful tamponade of extravasation of blood into the lungs.
See this image and copyright information in PMC

References

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