Innovative endovascular technique for treatment of rare cause of haemoptysis in young

Abstract

A 17-year-old boy reported for evaluation of two episodes of massive haemoptysis. His clinical examination was unremarkable and investigations (haemogram, coagulogram, serological tests for connective tissue disorders) were normal. A 64-slice CT angiography revealed a saccular aneurysm of 3.8×3.7×3.3 cm arising from the right lower lobe pulmonary artery which was confirmed by cardiac catheterisation. The aneurysm was successfully blocked with a 16-14 Amplatzer duct occluder. A repeat CT angiogram performed after 15 days revealed the device in situ obliterating the aneurysm. Pulmonary artery aneurysm is an extremely rare cause of massive haemoptysis and indicates imminent rupture of the aneurysm which can be rapidly fatal. This case highlights the importance of using an innovative endovascular technique for treatment of a rare cause of haemoptysis.

Figure 1

Posteroanterior chest radiograph showing ill-defined spherical non-homogenous opacity in the right upper zone.

Figure 2

64-Slice CT scan demonstrating the aneurysm of the descending branch of right pulmonary artery.

Figure 3

Selective right pulmonary artery angiogram done using the Judkins right catheter demonstrating the aneurysm.

Figure 4

A 16-14 Amplatzer duct occluder (AGA Medical Corp, USA) deployed into the aneurysm sac.

Figure 5

A 64-slice CT scan done 2 weeks postprocedure showing duct occluder device in situ along with obliteration of the aneurysm.