PULMONARY ARTERY PSEUDOANEURYSM: A RARE VASCULAR LESION AFTER RIGHT HEART CATHETERIZATION

  • André Gomes Serviço de Imagiologia Geral, CHLN - Hospital de Santa Maria
  • Paula Campos Serviço de Imagiologia Geral, CHLN - Hospital de Santa Maria
Keywords: Multidetector Computed Tomography, Aneurysm, False, Hemoptysis, Iatrogenic Disease, Catheterization, Swan-Ganz

Abstract

Pulmonary artery pseudoaneurysms may be caused by infection, trauma, neoplasm or iatrogenic lesions, such as pulmonary artery rupture during right heart artery catheterization. Clinical presentation can range from an incidental finding to a life-threatening bleeding with massive hemoptysis. We present a case of a 67 year old woman with systemic sclerosis that developed massive hemoptysis after right heart catheterization. Computer tomography angiography showed a pulmonary artery pseudoaneurysm in the posterior basal segmental branch of the left lower lobe. Computer tomography angiography usually allows pseudoaneurysm diagnosis, localization and characterization and can aid in therapeutic procedure planning. Without treatment pseudoaneurysms may enlarge or rupture. Although a rare complication, pulmonary artery pseudoaneurysms are associated with high morbidity and mortality, and should not be missed.

Downloads

Download data is not yet available.

References

1. Nguyen ET, Silva CI, Seely JM, et al. Pulmonary artery aneurysms and pseudoaneurysms in adults: findings at CT and radiography. AJR Am J Roentgenol. 2007;188(2). doi:10.2214/AJR.05.1652.
2. Quartey B, Jessie E. Pulmonary artery and vein pseudoaneurysm after gunshot wound to the chest. J Emerg Trauma Shock. 2011;4(2):313. doi:10.4103/0974-2700.82235.
3. Lafita V, Borge MA, Demos TC. Pulmonary artery pseudoaneurysm: Etiology, presentation, diagnosis, and treatment. Semin Intervent Radiol. 2007. doi:10.1055/s-2007-971202.
4. Kearney TJ, Shabot MM. Pulmonary artery rupture associated with the Swan-Ganz catheter. Chest. 1995;108(5):1349-1352.
5. Dieden JD, Friloux LA, Renner JW. Pulmonary artery false aneurysms secondary to Swan-Ganz pulmonary artery catheters. AJR Am J Roentgenol. 1987;149(5):901-906. doi:10.2214/ajr.149.5.901.
6. Pattanaik D, Brown M, Postlethwaite AE. Vascular involvement in systemic sclerosis (scleroderma). J Inflamm Res. 2011. doi:10.2147/JIR.S18145.
7. Ferretti GR, Thony F, Link KM, et al. False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management. AJR Am J Roentgenol. 1996;167(4):941-945. doi:10.2214/ajr.167.4.8819388.
8. Revel MP, Fournier LS, Hennebicque AS, et al. Can CT replace bronchoscopy in the detection of the site and cause of bleeding in patients with large or massive hemoptysis? AJR Am J Roentgenol. 2002;179(5):1217-1224. doi:10.2214/ajr.179.5.1791217.
9. Bruzzi JF, Remy-Jardin M, Delhaye D, et al. Multi-Detector Row CT of Hemoptysis. Radiographics. 2006;26(1):3-22. doi:10.1148/rg.261045726.
10. Karak P, Dimick R, Hamrick KM, et al. Immediate transcatheter embolization of Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm. Chest. 1997;111(5):1450-1452.
11. Rudziński PN, Demkow M, Michałowska I, et al. Endovascular treatment of PA pseudoaneurysm caused by Swan-Ganz catheter. Adv Interv Cardiol. 2014;1(3):66-70. doi:10.5114/pwki.2014.41476.
12. Rouquier J, Arrivé L, Masini JP, et al. [Spontaneous resolution of asymptomatic false aneurysm of the pulmonary artery induced by Swan-Ganz catheter]. J Radiol. 2001;82(12 Pt 1):1732-1734.
Published
2017-06-03
Section
Clinical Case