PMC4989997_01
Contrast-enhanced CT shows the pulmonary artery pseudoaneurysm (PAP) due to pulmonary aspergillosis in the left upper lobe (arrow).
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PAP in the left upper lobe (Figure 1). Pneumonectomy was considered but he was not a surgical candidate due to his chronic heart failure.
(A) Pulmonary angiography from the left pulmonary artery does not show the branch of the left upper lobe due to reverse flow from the systemic artery. (B) Systemic angiography from the fifth left intercostal artery shows the PAP (arrow). (C) Coronal maximum intensity projection CT image during angiography from the fifth left intercostal artery shows the posterior spinal artery (arrow). (D) A microcatheter was successfully advanced to the distal site of the PAP, and PAP was visualized obviously (arrow). Then, coil embolization was performed. (E) After coil embolization, angiography from the fifth left intercostal artery shows the disappearance of the PAP.
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Pulmonary angiography from the left pulmonary artery did not show the branch of the left upper lobe due to reverse flow from the systemic artery (Figure 2A). Systemic angiography using a 2.7-Fr. microcatheter (Sniper2; Terumo, Tokyo, Japan) from the fifth left intercostal artery showed the PAP at the distal site (Figure 2B). CA, USA). As a result, the CT images allowed visualization of the posterior spinal artery (Figure 2C), and the plan was changed to embolization from the pulmonary artery. Catheterization in the pulmonary artery was performed with reference to the angiographic image obtained for the intercostal artery. PAP (Figure 2D). The artery distal and proximal to the PAP was then successfully embolized using 0.010-inch coils (Target coil, Stryker, Fremont, CA, USA) to exclude it from circulation. Postembolization angiography showed no PAP filling (Figure 2E). Follow-up contrast-enhanced CT performed 5 days later revealed disappearance of the PAP (Figure 3).
Contrast-enhanced CT performed 5 days later shows the disappearance of the PAP (arrow).
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Fremont, CA, USA) to exclude it from circulation. Postembolization angiography showed no PAP filling (Figure 2E). Follow-up contrast-enhanced CT performed 5 days later revealed disappearance of the PAP (Figure 3).