REVIEW   

Il Giornale Italiano di Radiologia Medica 2019 Novembre-Dicembre;6(6):523-38

DOI: 10.23736/S2283-8376.19.00225-0

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

The role of interventional radiology in the management of thoracic oncological complications

Anna Maria IERARDI ¹ ✉, Enrico GARANZINI ², Stefania IANNIELLO ³, Simona VEGLIA ⁴, Francesca IACOBELLIS ⁵, Chiara ANDREOLI ⁶, Maria L. DE CICCO ⁶, Silvia STOLA ⁴, Federica ARABIA ⁴, Paolo D’ANDREA ⁷

¹ Department of Diagnostic and Interventional Radiology, ASST Santi Paolo e Carlo, San Paolo Hospital, University of Milan, Milan, Italy; ² Postgraduate School of Radiology, University of Milan, Milan, Italy; ³ Department of Emergency Radiology, S. Camillo Hospital, Rome, Italy; ⁴ Radiologia 2, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy; ⁵ Department of Radiology, A. Cardarelli Hospital, Naples, Italy; ⁶ Division of Emergency Surgery and Trauma, Department of Emergency, Umberto I General Hospital, Sapienza University, Rome, Italy; ⁷ Department of Radiology, San Martino Hospital, Belluno, Italy

Nowadays interventional radiology permits to treat several conditions not approachable in any other way. Oncological emergencies in patients with advanced cancer can be caused by a variety of underlying processes that can have several clinical presentations. They are divided into metabolic, hematologic and structural emergencies. In this article, we address the main structural thoracic oncological emergencies in patients with lung cancer, and its management with interventional radiology. Structural emergencies, such as vessel thrombosis, hemorrhage, infiltration or compression of the involved organs and vessels and obstruction of ducts or hollow viscera, require urgent imaging studies for a correct diagnosis and to plan the best treatments. In such serious scenarios, end-of-life decision making should be based on patient’s comfort and the optimization of quality of life. Interventional radiology procedures are mini-invasive procedures, such as embolization, endovascular thrombectomy or thrombolysis, drains or stents placement characterized by low rate of morbidity and mortality with high clinical success and safety.

KEY WORDS: Pulmonary embolism; Superior vena cava syndrome; Hemoptysis; Radiology, interventional; Neoplasms