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Peer-reviewedCC BYJournal of clinical medicine

Staged Preoperative Embolization Followed by ICG-Guided Parenchyma-Sparing Resection of Pulmonary Sequestration: A Case Report

  • Giuseppe Mangiameli1,2
  • Debora Brascia1,2
  • Giuseppe Ferrillo3
  • Giuseppe Marulli1,2
  1. 1Division of Thoracic Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
  2. 2Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy
  3. 3Department of Radiology, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
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Abstract

Pulmonary sequestration is a rare congenital malformation supplied by an aberrant systemic artery, making parenchyma-sparing resection technically challenging because safe vascular control and accurate identification of the resection plane are both required. Indocyanine green (ICG) fluorescence has been used to delineate the perfusion boundary between sequestrated and normal lung, whereas preoperative embolization has traditionally been performed to reduce the risk of intraoperative bleeding. We describe a staged approach in which selective coil embolization of the aberrant feeding artery, performed one day before surgery, was followed by video-assisted fluorescence-guided wedge resection. Preoperative embolization established devascularization before surgery, while subsequent ICG fluorescence provided clear real-time delineation of the perfusion boundary, enabling tailored parenchyma-sparing resection. Although this observation derives from a single case and does not support routine preoperative embolization, it raises the hypothesis that the interval between embolization and surgery may influence the physiological conditions under which subsequent fluorescence-guided perfusion assessment is performed. This potential effect requires confirmation through quantitative fluorescence assessment and comparative studies.

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Cite

BibTeXRIS
BibTeX
@article{mangiameli2026staged,
  title = {{Staged Preoperative Embolization Followed by ICG-Guided Parenchyma-Sparing Resection of Pulmonary Sequestration: A Case Report}},
  author = {Giuseppe Mangiameli and Debora Brascia and Giuseppe Ferrillo and Giuseppe Marulli},
  journal = {Journal of clinical medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15197635},
  url = {https://europepmc.org/article/PMC/PMC13666169},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Staged Preoperative Embolization Followed by ICG-Guided Parenchyma-Sparing Resection of Pulmonary Sequestration: A Case Report
AU  - Giuseppe Mangiameli
AU  - Debora Brascia
AU  - Giuseppe Ferrillo
AU  - Giuseppe Marulli
PY  - 2026
DA  - 2026/10/01
JO  - Journal of clinical medicine
DO  - 10.3390/jcm15197635
UR  - https://europepmc.org/article/PMC/PMC13666169
AB  - Pulmonary sequestration is a rare congenital malformation supplied by an aberrant systemic artery, making parenchyma-sparing resection technically challenging because safe vascular control and accurate identification of the resection plane are both required. Indocyanine green (ICG) fluorescence has been used to delineate the perfusion boundary between sequestrated and normal lung, whereas preoperative embolization has traditionally been performed to reduce the risk of intraoperative bleeding. We describe a staged approach in which selective coil embolization of the aberrant feeding artery, performed one day before surgery, was followed by video-assisted fluorescence-guided wedge resection. Preoperative embolization established devascularization before surgery, while subsequent ICG fluorescence provided clear real-time delineation of the perfusion boundary, enabling tailored parenchyma-sparing resection. Although this observation derives from a single case and does not support routine preoperative embolization, it raises the hypothesis that the interval between embolization and surgery may influence the physiological conditions under which subsequent fluorescence-guided perfusion assessment is performed. This potential effect requires confirmation through quantitative fluorescence assessment and comparative studies.
SN  - 2077-0383
ER  -