PMC4061436_01
Contrast-enhanced CT of the mediastinal level shows a big mass with contrast extravasation indicating active bleeding in the tumor.
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The CT ruled out a pulmonary embolism, but did reveal a large mass in the posterior mediastinum (Fig. 1) with an axial diameter of 5.5 cm and cranio-caudal diameter of 7.4 cm, that extended to the subcarinal level (Fig. 2).
Coronal multiplanar reformations show the cranio-caudal extend of the mass.
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The CT ruled out a pulmonary embolism, but did reveal a large mass in the posterior mediastinum (Fig. 1) with an axial diameter of 5.5 cm and cranio-caudal diameter of 7.4 cm, that extended to the subcarinal level (Fig. 2).
Selective angiography shows a large (pseudo)aneurysm of the left bronchial artery.
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Angiography was performed, demonstrating a large (pseudo)aneurysm of the left bronchial artery (Fig. 3).
Superselective coil embolization was performed with full occlusion of the feeding artery using fiber coils.
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Superselective embolization using coils was successfully carried out (Fig. 4) in a coaxial way, using a 5F Cobra catheter and a microcatheter for superselective embolization.
CT follow-up demonstrates full occlusion of the feeding artery and no active bleeding with disappearance of the mediastinal hematoma.
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Six weeks later, upon evaluation at the outpatient clinic, she was free of complaints and chest CT showed that the mediastinal hematoma had completely resolved (Fig. 5).