Page 13 - Read Online

Yanagawa et al. Vessel Plus 2018;2:1 I http://dx.doi.org/10.20517/2574-1209.2017.37 Page 5 of 8

39 de Jonge 2003 57 Male Penetrating Knife Pseudoaneurysm No specific Coil embolization Survive None
et al. [62]
40 Donaldson 2002 17 Male Penetrating Gun Pseudoaneurysm No specific Lobectomy Survive Yes CPC4
and Ngo-
Nonga [63]
41 Savage 1999 49 Male Penetrating Gun Pseudoaneurysm No specific Coil embolization Survive None
et al. [64]
42 Hubler 1997 20 Male Penetrating Knife Pseudoaneurysm No specific Lobectomy Survive None
et al. [65]
43 Huet et al. [66] 1996 29 Male Penetrating Gun Pseudoaneurysm No specific Stent Survive None
44 Giglioli 2013 46 Female Blunt ? Fistula Right cardiac Pericardial patch Survive None
et al. [10] (aortopulmonary) failure
45 Rrapo 2013 20 Male Penetrating Gun Fistula ARDS Pericardial patch Survive None
et al. [11] (pulmonary)
46 Roshanali 2012 48 Female Penetrating Missile Fistula TIA Plug occlusion Survive None
et al. [12] debris (pulmonary)
47 Howell 2004 24 Male Penetrating Knife Fistula No specific Operation Survive None
et al. [67] (aortopulmonary)
48 Kerr and 1993 35 Male Penetrating Knife Fistula Short of Embolization Survive None
Sauter [68] (pulmonary) breath
49 Almdahl 2014 46 Female Blunt ? Dissection No specific Conservative Survive None
et al. [16]
50 Chung 2009 53 Male Blunt Boat Dissection No specific Nitric oxide Dead None
et al. [17] accident
?: not described; ARDS: acute respiratory distress syndrome; TIA: transient ischemic attack; MOF: multiple organ failure; PEA: pulseless electrical activity;
CPC: cerebral performance category; PAI: pulmonary artery injury

Table 2. Summary of non-iatrogenic injury of the pulmonary artery since 1990

Total 50 cases
Age, years Range 5-91
Average 38.4
Gender Male 40 (80%)
Female 10 (20%)
Type of injury Blunt 19 (38%)
Penetrating 31 (62%)
Cause of injury Gun 15 (30%): shot gun, air gun include
Traffic accident 13 (32%)
Knife 10 (20%)
Others 9 (18%)
Type of PAI Rupture 26 (52%)
Pseudoaneurysm 17 (34%)
Fistula 5 (10%)
Dissection 2 (4%)
Symptom Hemothorax 21 (42%)
No specific 20 (40%)
Tamponade 3 (6%)
Others 3 (6%)
Treatment Surgical sutures 22 (44%)
Endovascular 10 (20%): include coil, stent and other materials
Conservative 6 (12%)
Other surgical maneuver 10 (20%)
Other treatment 2 (4%)
Survival Number and rate 46 (92%)
PAI: pulmonary artery injury

procedures are the most common cause of iatrogenic PAI rupture and pseudoaneurysm, with PA catheters
being a particularly common culprit. Non-iatrogenic PAIs occur due to chest trauma but most chest trauma
does not involve PAI. Penetrating injuries were more frequent than blunt injuries. The diagnosis was made
based on intraoperative findings, enhanced CT or pulmonary arteriography. The main treatment method
was surgery or an interventional approach. If PAI can be managed appropriately and promptly in patients
without cardiac arrest, the patient may be saved.