Pulmonary artery stenting for palliative treatment of refractory hypoxaemia in a patient with small cell lung cancer

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Abstract
Pulmonary artery stenosis (PAS) is most encountered in the paediatric population as a congenital anomaly. In adults, PAS from extrinsic compression of the pulmonary artery (PA) results from conditions such as fibrosing mediastinitis, malignancy, infections and anastomotic stenosis after lung transplantation. We describe a woman in her 50s with extensive stage small cell lung cancer who presented with symptoms of shortness of breath and hypoxaemic respiratory failure. CT angiography chest showed a progressively enlarging mediastinal mass causing severe compressive stenosis of the right PA and moderate stenosis of the left PA. Her symptoms did not improve despite using bronchodilators and intravenous steroids. Pulmonary angiography confirmed clinically significant stenosis of her right PA. The placement of a single stent within the right PA provided significant improvement in symptoms and supplemental oxygen requirement within 24 hours.

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