PMC9909035_01
CT angiogram demonstrating the aorta-to-pulmonary central shunt that originates from the under-side of the distal transverse artic arch immediately underneath the origin of the left subclavian artery. The proximal LPA is not visualized. The LPA reconstitutes distally and is diffusely hypoplastic.
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F1
As part of her assessment for low oxygen saturation, a CT scan was performed and demonstrated near-complete occlusion of her LPA and narrowing of her left main stem bronchus (Figure 1).
(A) Angiogram with a 4 Fr Glide catheter via the right carotid artery sheath demonstrates thrombus in the mid-to-distal central shunt (yellow arrow) and no contrast seen in the LPA. (B, C) On serial angiography following mechanical thrombectomy, the area of lucency is no longer present and there is improved flow in the LPA.
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F2
Although no thrombus was detected in the filter, there was a decrease in the size of the thrombus in the central shunt and LPA on serial angiography, with new evidence of flow seen to the distal LPA (Figure 2).