Article Sidebar
Published:
Jan 30, 2024Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
Transcatheter vascular plugs for the treatment of massive haemoptysis from Rasmussen aneurysms
Abstract
Rasmussen aneurysms are abnormalities of the pulmonary arterial system caused by tuberculosis (TB). They are associated with a high mortality rate when they cause life-threatening haemoptysis. High TB-prevalence regions have a large burden of TB-related haemoptysis but often limited resources. This series of 25 patients who presented with life-threatening haemoptysis from current and/or previous TB were found to have abnormal pulmonary arteries on computed tomography pulmonary angiogram (CTPA), which were judged to be likely contributors to their bleeding, either in isolation or with concomitant abnormal bronchial or systemic vasculature. These patients underwent transcatheter placement of Amplatzer vascular plugs in the feeder pulmonary artery. Bronchial and systemic lesions were addressed separately as needed. Immediate technical success was achieved in all patients, but four of them experienced intraoperative haemoptysis related to dislodgement of the occluding platelet plug by the high-pressure automatic injector and wire. At 48 hours after the procedure, 18 (72%) remained haemoptysis-free. Six of these experienced recurrence within 1 year of their procedure. Pulmonary artery placement of an Amplatzer vascular plug is a feasible option for treating bleeding Zasmussen aneurysms, but should be part of a combined approach to addressing suspected culprit vascular lesions in all intrathoracic vascular systems.
