PMC8349102_01
(A) Computed tomography image showing a nodule in the left lower lobe. (B) Contrast-enhanced computed tomography showing inflow of contrast medium into the nodule and (C) the connection between the nodules and pulmonary artery. (D) Computed tomography angiography showing the aneurysm associated with the left inferior phrenic artery-to-left pulmonary artery fistula.
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Chest X-ray screening yielded normal findings; however, computed tomography (CT) revealed a nodule in the left lower lobe (Fig. 1A). CT showed an inflow of contrast medium into the nodule as well as a connection between the nodules and pulmonary artery (Fig. 1B and C). CT angiography detected an aneurysm associated with a left inferior phrenic artery-to-left pulmonary artery fistula (Fig. 1D).
(A) Angiography of the left pulmonary artery did not indicate the presence of an aneurysm. (B) Angiography of the left inferior phrenic artery revealed the presence of an aneurysm associated with a left inferior phrenic artery-to-left pulmonary artery fistula. (C) Following embolization, there was no inflow into the aneurysm.
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Although the aneurysm was not imaged from the left pulmonary artery (Fig. 2A), it was found to be associated with the left inferior phrenic artery-to-left pulmonary artery fistula when observed in the left phrenic artery (Fig. 2B). We performed coil-assisted embolization of the inferior phrenic artery using n-butyl cyanoacrylate-lipiodol, after which angiographic examination of the left inferior phrenic artery no longer showed inflow of contrast medium into the aneurysm (Fig. 2C).
During follow-up, a month after the treatment, a chest X-ray revealed the presence of embolic material.
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During follow-up a month after the TAE was performed, a chest X-ray examination indicated that the location of the embolic material was not of major concern (Fig. 3).