PMC4900122_01
28-year-old male with massive hemoptysis and recurrent intractable hemoptysis. Frontal chest radiograph: right-sided aortic arch, diminutive left hilum, small left lung hemithorax, and left-sided rib notching (white arrows).
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Chest radiography upon arrival at a community emergency room showed a right-sided aortic arch, diminutive left hilum, small left hemithorax, and left-sided rib notching (Fig. 1).
28-year-old male with massive hemoptysis and recurrent intractable hemoptysis. CT pulmonary angiogram: right-sided aortic arch, absent left pulmonary artery, and dilated aortopulmonary collateral arteries.
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A CT pulmonary angiogram revealed proximal interruption of the left pulmonary artery and enlarged systemic collaterals (Fig. 2).
28-year-old male with massive hemoptysis and recurrent intractable hemoptysis. Catheter angiography: Dilated tortuous bronchial and intercostal arteries arising from a right-sided aortic arch.
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Thoracic aortography showed multiple enlarged bronchial, intercostal, and phrenic collaterals with significant neovascularity (Fig. 3a). Angiography of the seventh and ninth intercostal arteries demonstrated communication to the anterior spinal artery, preventing safe embolization of these vessels (Fig. 3b).