Permanent Cortical Blindness After Bronchial Artery Embolization

• Published in: Cardiovascular and interventional radiology Vol. 36; no. 6; pp. 1686 - 1689
• Main Authors: van Doorn, Colette S., De Boo, Diederick W., Weersink, Els J. M., van Delden, Otto M., Reekers, Jim A., van Lienden, Krijn P.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.12.2013; Springer Nature B.V
• Subjects: Adult; ARTERIES; BIOMEDICAL RADIOGRAPHY; Blindness, Cortical - diagnostic imaging; Blindness, Cortical - etiology; Bronchial Arteries - abnormalities; Bronchial Arteries - diagnostic imaging; BYPASSES; Cardiology; Case Report; Contrast Media; Cystic Fibrosis - complications; Embolization, Therapeutic - adverse effects; Female; FIBROSIS; Gelatin Sponge, Absorbable - adverse effects; Hemoptysis - etiology; Hemoptysis - therapy; Humans; HYPERTROPHY; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Radiographic Image Enhancement - methods; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Subclavian Artery - abnormalities; Subclavian Artery - diagnostic imaging; Tomography, X-Ray Computed - methods; Treatment Outcome; Ultrasound; VASCULAR DISEASES; Posterior Circulation; Vertebral Artery; Subclavian Artery; Embolization Material; Bronchial Artery
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-013-0610-6

A 35-year-old female with a known medical history of cystic fibrosis was admitted to our institution for massive hemoptysis. CTA depicted a hypertrophied bronchial artery to the right upper lobe and showed signs of recent bleeding at that location. Bronchial artery embolization (BAE) was performed with gelfoam slurry, because pronounced shunting to the pulmonary artery was present. Immediately after BAE, the patient developed bilateral cortical blindness. Control angiography showed an initially not opacified anastomosis between the embolized bronchial artery and the right subclavian artery, near to the origin of the right vertebral artery. Cessation of outflow in the bronchial circulation reversed the flow through the anastomosis and allowed for spill of embolization material into the posterior circulation. Unfortunately the cortical blindness presented was permanent.