PMC3863966_01
CT findings. (a) Chest CT shows diffuse GGO and thickened interlobular pleura in the left lower lobe. (b) Contrast-enhanced CT shows the anomalous artery arising from the descending thoracic aorta (arrow).
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Subsequently, contrast-enhanced CT showed diffuse ground-glass opacity (GGO) and thickened interlobular pleura in the left lower lobe, indicating pulmonary congestion (Fig. 1a). The normal pulmonary artery that accompanies a bronchus could not be identified in the left basal segment of the lung, which was supplied by an anomalous artery, 7 mm in diameter, originating from the descending thoracic aorta (Fig. 1b).
Angiographic findings and treatment. (a) Pulmonary arteriography shows the absence of pulmonary branches in the left basal segments. (b) Thoracic aortography shows an anomalous artery arising from the lower thoracic descending aorta. (c) Selective angiography of the anomalous artery under balloon occlusion (arrow) shows irregularities in the peripheral branches. (d) Thoracic aortography post embolization shows disappearance of the anomalous artery.
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Then, thoracic aortography and pulmonary arteriography were performed. The angiographic examinations confirmed the absence of pulmonary branches in the left basal segments (Fig. 2a), and showed an anomalous artery originating from the lower thoracic descending aorta (Fig. 2b), with the normal lower pulmonary vein flowing into the left atrium in the venous phase. The diameter of the inferior and upper pulmonary veins was almost equivalent, and no enlargement was apparent. USA) was then advanced to the distal section of the anomalous artery. Under balloon occlusion (Fig. 2c), we performed embolization from the distal site of the main trunk to the origin, using five fibered IDC coils (Interlock; Boston Scientific, Natick, MA, USA) and 13 platinum coils (Tornade; Cook, Bloomington, IN, USA). Post-embolization angiography showed disappearance of the anomalous artery (Fig. 2d).