Key result
Anticoagulation with low-molecular-weight heparin led to symptom improvement and almost complete resolution of pulmonary artery stump thrombosis at 4 months in a post-pneumonectomy patient.
Why the study?
Pathophysiological mechanisms of pulmonary artery stump thrombosis remain unknown and the decision to treat with anticoagulants is controversial.
Does anticoagulation resolve thrombus and improve symptoms in patients with late-occurring pulmonary artery stump thrombosis?
Case Report (n=1)
Does anticoagulation resolve thrombus and improve symptoms in patients with late-occurring pulmonary artery stump thrombosis?
Anticoagulation with low-molecular-weight heparin may be an effective treatment for symptomatic, late-occurring pulmonary artery stump thrombosis with convex-shaped thrombi.
May support LMWH for symptomatic late stump thrombosis; hypothesis-generating and requires prospective confirmation.
Pulmonary artery stump thrombosis (PAST) represents a possible complication after lung surgery. We report the case of a 59-year-old man who presented with dyspnoea about 4 years after right pneumonectomy due to squamous cell lung cancer. A CT-scan showed the presence of pulmonary artery stump thrombosis. Although there was no evidence of pulmonary embolism, given the clinical features and radiological shape of the thrombus, anticoagulation treatment with low-molecular-weight heparin was started with improvement of symptoms. The patient was discharged on anticoagulant treatment and a pulmonary CT-scan performed 4 months later showed an almost complete resolution of the PAST. Pathophysiological mechanisms of PAST are still unknown, although several hypotheses have been proposed. However, the decision to treat PAST with anticoagulants is still controversial. A review of literature will be provided in order to discuss risk factors, possible etiologies and to highlight clinical and radiological characteristics that could suggest to treat this condition, in particular when there is an increased risk of complications.
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Mirijello et al. (2021) conducted a case report in Pulmonary artery stump thrombosis (PAST) (n=1). Low-molecular-weight heparin was evaluated on Resolution of pulmonary artery stump thrombosis on CT-scan. Anticoagulation with low-molecular-weight heparin led to symptom improvement and almost complete resolution of pulmonary artery stump thrombosis at 4 months in a post-pneumonectomy patient.
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