Practical Considerations for Endovascular Treatment of Pulmonary Sequestration-Induced Hemoptysis: Two Case Reports and Review of Literature

Abstract

Pulmonary sequestration is a rare condition in which a segment or lobe of dysplastic lung tissue develops without connecting to the airways and pulmonary arteries. Hemoptysis is a potentially fatal complication of pulmonary sequestration. The current report discusses two complex cases of pulmonary sequestration. The first involves a patient with coexisting partial anomalous pulmonary venous drainage, in which hemoptysis was effectively managed through embolization of the abnormal systemic artery. Embolization of the anomalous pulmonary vein was not performed because the left-to-right shunt was hemodynamically insignificant. The second case involved a patient with a multi-cystic lung mass and air-fluid levels. Although embolization of the abnormal systemic artery controls hemoptysis, it also leads to prolonged complications due to aggravated inflammation. When providing endovascular treatment for pulmonary sequestration, conducting a comprehensive evaluation using pretreatment imaging is necessary to tailor the approach to each patient's unique condition.