Pulmonary artery stump thrombosis describes thrombus formation occurring at the site of the pulmonary arterial stump, a complication following lobectomy or pneumonectomy. It is usually discovered as an incidental finding on routine follow-up chest CT scans.
The prevalence of pulmonary artery stump thrombosis after pneumonectomy is approximately 12% 1.
Is thought to be an in situ thrombus caused by stasis of blood flow 2. Although the right pulmonary stump is longer than the left post-pneumonectomy, which may promote a greater degree of stasis, interestingly studies have been inconclusive regarding whether they occur more commonly on one side or the other 8.
Treatment and prognosis
Some publications suggest anticoagulation to be considered for convex stump thrombus or a new stump thrombus in the context of declining pulmonary status.
- pulmonary embolism to contralateral lung, occurring in less than 10% in cases 6,8
- 1. Sawalha L, Mador MJ. Delayed post-lobectomy pulmonary artery stump thrombosis. (2015) Respiratory medicine case reports. 15: 36-8. doi:10.1016/j.rmcr.2015.04.003 - Pubmed
- 2. Kim SY, Seo JB, Chae EJ, Do KH, Lee JS, Song JW, Song KS, Lim TH. Filling defect in a pulmonary arterial stump on CT after pneumonectomy: radiologic and clinical significance. (2005) AJR. American journal of roentgenology. 185 (4): 985-8. doi:10.2214/AJR.04.1515 - Pubmed
- 3. Kwek BH, Wittram C. Postpneumonectomy pulmonary artery stump thrombosis: CT features and imaging follow-up. (2005) Radiology. 237 (1): 338-41. doi:10.1148/radiol.2371041686 - Pubmed
- 4. Barbetakis N, Asteriou C, Kleontas A. Post-lobectomy pulmonary artery stump thrombosis: how dangerous is it?. (2011) The Annals of thoracic surgery. 91 (3): e44. doi:10.1016/j.athoracsur.2010.12.037 - Pubmed
- 5. Kotoulas C, Lachanis S. Embolism of the pulmonary artery stump after right pneumonectomy. (2009) Interactive cardiovascular and thoracic surgery. 8 (5): 563-4. doi:10.1510/icvts.2008.189415 - Pubmed
- 6. Sato W, Watanabe H, Sato T, Iino K, Sato K, Ito H. Contralateral pulmonary embolism caused by pulmonary artery stump thrombosis after pneumonectomy. (2014) The Annals of thoracic surgery. 97 (5): 1797-8. doi:10.1016/j.athoracsur.2013.07.102 - Pubmed
- 7. Thomas PA, Doddoli C, Barlési F, Reynaud-Gaubert M, Giudicelli R, Fuentes P. Late pulmonary artery stump thrombosis with post embolic pulmonary hypertension after pneumonectomy. (2006) Thorax. 61 (2): 177-8. doi:10.1136/thx.2004.028480 - Pubmed
- 8. Joshi M, Farooq U, Mehrok S, Srouji N. Delayed formation of pulmonary artery stump thrombus: a case report and review of the literature. (2009) Thrombosis journal. 7: 7. doi:10.1186/1477-9560-7-7 - Pubmed