Frequency and Predictors of Pulmonary Arterial Stump Thrombosis following Pneumonectomy or Lobectomy

• Published in: Medical principles and practice Vol. 31; no. 2; pp. 174 - 179
• Main Authors: Gurel Durmus, Zerrin, Bulbul, Yilmaz, Tekinbas, Celal, Seyis, Kubra Nur, Kosucu, Polat
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01-05-2022
• Subjects: Anticoagulants; Blood clots; Lung cancer; Original Paper; Ostomy; Pneumonectomy; Pulmonary arteries; Pulmonary embolisms; Regression analysis; Risk factors; Thoracic surgery; Thorax; Thrombosis; Veins & arteries; Stump thrombosis; Pneumonectomy; Lobectomy; Thrombosis; Lung cancer; Pulmonary artery
• ISSN: 1011-7571; 1423-0151
• DOI: 10.1159/000522095

Objectives: Pulmonary artery stump thrombosis (PAST) following pneumonectomies/lobectomies is rare; its clinical importance is unknown. The objectives of this study were to analyze the prevalence and risk factors of PAST and the clinical significance in patients with pneumonectomy/lobectomy. Methods: All adult cases who underwent pneumonectomy/lobectomy in our hospital for any reason and who underwent control contrast-enhanced thoracic CT during the follow-up period were included in the study. Demographic and clinical features of the patients, data on surgery, and the features of thrombi were recorded. Results: During the 4-year study period, a total of 454 patients underwent pneumonectomy/lobectomy (93 pneumonectomy and 361 lobectomy). Among the patients, 202 patients (50 pneumonectomy and 152 lobectomy) with at least one follow-up thorax CT were included in the analyses. PAST was detected in 9 (4.5%) of 202 patients and mostly seen in patients with pneumonectomy (lobectomy: 2.6% vs. pneumonectomy: 10%, p = 0.043) and in patients whose pulmonary artery was ligated by using stapler (suture ligation 1% vs. stapler: 7.4%, p = 0.034). Pulmonary artery stump was also longer in patients with PAST (8.48 ± 11.22 mm vs. 23.55 ± 11.22 mm, p < 0.001). Univariate logistic regression analysis showed that pneumonectomy and longer pulmonary artery stump length were found to be significantly associated with PAST (p = 0.041 and p = 0.001, respectively). Conclusions: PAST was detected in 4.5% of our subjects undergoing lobectomy/pneumonectomy. PAST was found to be significantly higher in subjects who underwent pneumonectomy, those with longer pulmonary artery stump, and those with pulmonary artery stump ligated by using stapler.