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Case Reports
. 2015 Jul 29;1(3):20150064.
doi: 10.1259/bjrcr.20150064. eCollection 2015.

Endovascular treatment of a pulmonary artery pseudoaneurysm caused by Swan-Ganz catheter deployment in an anticoagulated patient

A M Ierardi  1 , G Xhepa  1 , A M Musazzi  2 , M De Chiara  1 , C Beghi  2 , G Carrafiello  1
Affiliations
Case Reports

Endovascular treatment of a pulmonary artery pseudoaneurysm caused by Swan-Ganz catheter deployment in an anticoagulated patient

A M Ierardi et al. BJR Case Rep. .

Abstract

We present a case report of an anticoagulated 78-year old man presenting a pulmonary artery pseudoaneurysm following Swan-Ganz catheter deployment after an aortic valve and aortic root replacement. Diagnosis was established by cone beam CT angiography and catheter angiographyand embolisation was achieved via a combination of plug and glue. This case emphasises the importance of endovascular techniques in the management of iatrogenic pulmonary pseudoaneurysms and shows the benefit of using highly hemostatic polymeric agent in anticoagulated patients to obtain a rapid and effective occlusion.

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Figures

Figure 1.
Figure 1.
Chest radiograph performed in the recovery room showing a right basal pleural effusion.
Figure 2.
Figure 2.
CT angiography showing the presence of a pulmonary artery pseudoaneurysm (arrow; a); maximum intensity projection reconstruction confirms arterial feeding (arrow; b).
Figure 3.
Figure 3.
Coronal view of cone-beam CT angiography documenting the pseudoaneurysm.
Figure 4.
Figure 4.
Angiography following selective catheterization of the medial segment branch of the right middle lobe pulmonary artery showing the pseudoaneurysm (arrow).
Figure 5.
Figure 5.
The angiogram performed following plug deployment documented persistent filling of the pseudoaneurysm (a); the angiogram performed after embolization with N-butyl cyanoacrylate revealed complete embolization (b).
See this image and copyright information in PMC

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