Pulmonary artery pseudoaneurysm after a left upper sleeve lobectomy

Salvage endovascular embolization of the left pulmonary artery for recurrent pseudoaneurysm

Background

Pulmonary pseudoaneurysm (PPA) is a potentially lethal complication of lung resection with a high risk of recurrence after endovascular coiling.

Case presentation

We report a case in which recurrent hemoptysis due to PPA after left lower lobe sleeve resection was treated by endovascular embolization of the left main pulmonary artery as a salvage treatment. The first hemoptysis was managed by endovascular coil embolization with extracorporeal membrane oxygenation, but refractory hemorrhage occurred 3 months later due to penetration of the endovascular coil into the bronchial anastomosis site. Because left completion pneumonectomy was considered too high risk, the left main pulmonary artery was palliatively embolized using an Amplatzer vascular plug (St. Jude Medical, MN, USA) to totally disrupt the left pulmonary arterial flow.

Conclusions

Total embolization of the left main pulmonary artery for repeated PPA rupture may be useful as a palliative treatment in patients unable to tolerate pneumonectomy.

Late presentation of pulmonary artery pseudoaneurysm following bronchovascular sleeve resection of lung

A 43-year-old man with a history of double sleeve right upper lobectomy for pulmonary sarcoma, presented with worsening haemoptysis. Bronchoscopic and positron emission tomography (PET)CT appearances were suspicious for disease recurrence; however, on attending for CT-guided biopsy, he was found to have a large pseudoaneurysm of his right pulmonary artery. The patient underwent placement of endovascular covered stent with fluoroscopic confirmation of pseudoaneurysm occlusion, and was discharged home on lifelong antiplatelet therapy. To our knowledge, this is the first reported case of pulmonary artery pseudoaneurysm following double (bronchovascular) sleeve resection of the lung, successfully treated by endovascular stenting.

Pulmonary Artery Pseudoaneurysm with Recurrent Massive Haemoptysis: Endovascular Management by a Covered Stent

Pulmonary artery pseudoaneurysm (PAPA) is a potentially fatal, albeit rare cause of hemoptysis. With a varied etiology and debatable management, time is the essence in its treatment. We present a case of a post lobectomy PAPA with recurrence of malignancy, managed via endovascular approach in a low resource setting where an ideal hardware was not available.

Fatal rupture of pulmonary artery pseudoaneurysm after thoracic radiation therapy against lung squamous cell carcinoma: A case report and literature review

Pulmonary artery pseudoaneurysm is a rare but fatal condition. It has been associated with lung cancer, abscesses, and radiation therapy. Identification in patients with hemoptysis is critical, and timely interventional therapy is warranted.

Penetrating chest trauma after attempted suicide: An extraordinary behavior of a posttraumatic pulmonary artery pseudoaneurysm

Posttraumatic pulmonary artery pseudoaneurysm is a very rare, yet potentially lethal complication after thoracic trauma. Pulmonary artery pseudoaneurysm is associated with high mortality. Still literature highlights that untreated, lesions can enlarge, rupture, and lead to exsanguination and death. We present a case of a posttraumatic peripheral pulmonary artery pseudoaneurysm with complete disappearance after one year. This case confirms that conservative treatment can be an effective option in asymptomatic and stable patients.

Left pulmonary artery pseudoaneurysm secondary to post-operative lung abscess

A prompt diagnosis is mandatory to avoid fatal complications in case of pulmonary artery pseudoaneurysm.

Post-operative imaging of pulmonary vessels

Complications following cardiothoracic surgery are responsible for prolonged hospital stay, increase cost in patient care and increased morbidity and mortality. Vascular complications in particular are significant contributors to poor patient outcome due to either hemorrhage or thrombosis and ischemia. Evaluation of vascular complications in the postoperative patient requires a rapid and reliable imaging approach. Vascular complications after cardiothoracic surgery include pulmonary artery thrombosis, pseudoaneurysm, pulmonary vein thrombosis, vascular fistulas, stenosis and infarction. Multidetector CT (MDCT), often the imaging modality of choice, offers a one-stop-shop capability to visualize the entire cardiothoracic vasculature, airways, lung parenchyma, mediastinum and chest wall with excellent temporal and spatial resolution.

Pseudoaneurysm of pulmonary artery: rare complication of systemic chemotherapy

Pulmonary artery pseudoaneurysm is an uncommon yet fatal clinical entity. Its presentation can mimic a number of common diseases and can be easily missed. As pseudoaneurysm is associated with a number of fatal complications, clinicians should be aware of imaging features which distinguishes pseudoaneurysms from its close differentials. Early recognition and treatment of pseudoaneurysm can prevent fatal outcomes including hemothorax, rupture, or death.