Clinical Image
Percutaneous Approach for a Rasmussen Aneurysm
Diego de Lacerda Barbosa, Júlia de Toledo-Mendes, Edson Marchiori
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Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Castro, Felipe Cortopassi, Russell Sabbag, Luis Torre-Bouscoulet, Claudia Kümpel, Elias Ferreira Porto" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Antonio A.M." "apellidos" => "Castro" ] 1 => array:2 [ "nombre" => "Felipe" "apellidos" => "Cortopassi" ] 2 => array:2 [ "nombre" => "Russell" "apellidos" => "Sabbag" ] 3 => array:2 [ "nombre" => "Luis" "apellidos" => "Torre-Bouscoulet" ] 4 => array:2 [ "nombre" => "Claudia" "apellidos" => "Kümpel" ] 5 => array:2 [ "nombre" => "Elias Ferreira" "apellidos" => "Porto" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289612000968?idApp=UINPBA00003Z" "url" => "/03002896/unassign/S0300289612000968/v2_201305131254/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Image</span>" "titulo" => "Percutaneous Approach for a Rasmussen Aneurysm" "tieneTextoCompleto" => true "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Diego de Lacerda Barbosa, Júlia de Toledo-Mendes, Edson Marchiori" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Diego" "apellidos" => "de Lacerda Barbosa" ] 1 => array:2 [ "nombre" => "Júlia" "apellidos" => "de Toledo-Mendes" ] 2 => array:4 [ "nombre" => "Edson" "apellidos" => "Marchiori" "email" => array:1 [ 0 => "edmarchiori@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1273 "Ancho" => 1400 "Tamanyo" => 187305 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Enhanced coronal (A) and axial (B) computed tomography images showing an inhomogeneous round opacity in the left upper lobe, with a nodular formation showing intense contrast uptake inside, compatible with Rasmussen's aneurysm. Enhanced coronal (C) and axial (D) computed tomography images acquired 48<span class="elsevierStyleHsp" style=""></span>h after treatment demonstrated the adequate filling of the Rasmussen's aneurysm with embolizing material, with no indication of new bleeding.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old man recently diagnosed with pulmonary tuberculosis presented to the emergency department due to cough and daily hemoptysis episodes (50–100<span class="elsevierStyleHsp" style=""></span>ml blood/episode). While hospitalized, he experienced a severe massive bleeding episode, prompting emergency fiberoptic bronchoscopy that revealed a clot obstructing the left main bronchus. Chest computed tomography demonstrated the presence of a round opacity in the left upper lobe, with a nodular formation with intense contrast uptake inside, compatible with Rasmussen aneurysm (RA; <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1A and B</a>). The patient underwent angiography of the pulmonary and bronchial arteries, which did not demonstrate aneurysmal formation. Ultrasound-guided aneurysmal sac puncture using a 22G Chiba needle and percutaneous embolization with a cyanoacrylate/Lipiodol® solution under fluoroscopic visualization were performed. The RA was adequately filled with embolizing material (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1C and D</a>). The patient was discharged 3 days after the procedure, and was completely asymptomatic after 1 year of follow up. Tuberculosis is a significant cause of hemoptysis globally, especially in developing countries, and RA is a rare but life-threatening complication. For most cases of RA, especially those with life-threatening hemoptysis, safer and less-invasive endovascular therapy with embolization has replaced surgical intervention. In some cases, however, percutaneous injection therapy can be considered because embolization of the pulmonary or bronchial arteries alone may fail to control the hemoptysis.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1,2</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of Interests</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors state that they have no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of Interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1273 "Ancho" => 1400 "Tamanyo" => 187305 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Enhanced coronal (A) and axial (B) computed tomography images showing an inhomogeneous round opacity in the left upper lobe, with a nodular formation showing intense contrast uptake inside, compatible with Rasmussen's aneurysm. Enhanced coronal (C) and axial (D) computed tomography images acquired 48<span class="elsevierStyleHsp" style=""></span>h after treatment demonstrated the adequate filling of the Rasmussen's aneurysm with embolizing material, with no indication of new bleeding.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Peripheral pulmonary arterial pseudoaneurysms: therapeutic implications of endovascular treatment and angiographic classifications" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Shin" 1 => "T. Shin" 2 => "H. Choi" 3 => "J. Choi" 4 => "Y. Kim" 5 => "C. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.10091416" "Revista" => array:7 [ "tituloSerie" => "Radiology" "fecha" => "2010" "volumen" => "256" "numero" => "2" "paginaInicial" => "656" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20656846" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT-guided percutaneous embolization of a rasmussen aneurysm with ethylene vinyl alcohol copolymer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Conde Vasco" 1 => "N. Costa" 2 => "J. Luz" 3 => "F. Veloso Gomes" 4 => "T. Bilhim" 5 => "E. Coimbra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "J Vasc Interv Radiol" "fecha" => "2019" "volumen" => "30" "numero" => "6" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/unassign/S030028962400379X/v1_202410210414/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/03002896/unassign/S030028962400379X/v1_202410210414/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962400379X?idApp=UINPBA00003Z" ]
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