Therapeutic Embolization of Anomalous Systemic Arterial Supply to the Normal Basal Segments of the Left Lower Lobe-A Safe Alternative to Surgery

Anomalous systemic arterial supply to the normal basal segments of the left lower lobe is a rare congenital anomaly. Although most cases are asymptomatic, treatment is recommended for all patients with or without symptoms because of their potential risk for hemoptysis due to pulmonary hypertension and heart failure due to systemic artery-to-pulmonary vein shunt. There are several surgical procedures available for this rare disease, including lobectomy, ligation or anastomosis of the anomalous systemic artery. Transarterial embolization is a new and semi-invasive technique compared with surgical treatment. Here we describe one 3 month-old female infant with congestive heart failure and one 13 year-old girl with mitral regurgitation and hemoptysis. Computed tomography and angiography demonstrated anomalous systemic artery supply to the left lower lung without coexistence of pulmonary sequestration in both cases. Both patients underwent successful coil embolization of the anomalous artery. Our experience suggests that transarterial etubolization could be a safe and effective alternative method to surgery.