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Case Reports
. 2021 Feb 24;16(5):1068-1071.
doi: 10.1016/j.radcr.2021.02.029. eCollection 2021 May.

Successful embolization of giant pulmonary artery pseudoaneurysm using coils and ethylene vinyl alcohol copolymer (Onyx)

Noémie Lutz  1 , Sylvain Grange  1 , Christian Sanson  2 , Rémi Grange  1
Affiliations
Case Reports

Successful embolization of giant pulmonary artery pseudoaneurysm using coils and ethylene vinyl alcohol copolymer (Onyx)

Noémie Lutz et al. Radiol Case Rep. .

Erratum in

Abstract

Hemoptysis could be a life-threatening event, especially when the bleeding originates from the arterial pulmonary circulation. The main cause of this type of bleeding is pulmonary artery pseudoaneurysm (PAP), which can be managed by surgical, medical or minimally invasive techniques. This study reports the case of massive hemoptysis in a 75-year-old male patient, with a former history of lobectomy. The initial CT scan showed a giant PAP from a branch of the right middle lobar pulmonary artery, within the right lower lobectomy cavity. An endovascular approach was decided. Subsequently, the feeding artery of the PAP was embolized with detachable coils. The control CT scan showed a persistent opacification of the PAP. The embolization was then completed by injection of Onyx within coils packing, with a complete thrombose of the PAP on control CT scan. This report confirms the safety and efficacy profile of an endovascular approach to treat giant PAP, using a combination of coils and Onyx.

Keywords: Embolization; Hemoptysis; Lung; Pulmonary artery pseudoaneurysm.

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Figures

Fig. 1:
Fig. 1
Chest computed tomography (CT) scans with arterial time injection in sagittal, axial section, in the long axe of the aneurysm sac (a-c), in mediastinal window and axial section in parenchymal window (d) show contrast media filling of the aneurysm sac in the right lower lobectomy cavity (*), feeding from the middle pulmonary artery (black arrow). Contrast-enhancement (white arrows) and air (arrow's head) within the lobectomy cavity suggest an infection.
Fig. 2:
Fig. 2
Angiographic opacification of the right pulmonary artery at the beginning of the second procedure (a) shows persistent filling of the coil packing (white arrow) and the aneurysmal sac (*) by iodine contrast. Angiographic opacification after adjunction of Onyx (b) shows no more filling of coil packing (black arrow) and the aneurysmal sac.
Fig. 3:
Fig. 3
Chest computed tomography (CT) scans with arterial time of injection, 1 month after the second procedure, (sagittal section in mediastinal window (a) and axial section in parenchymal window (b)), show a regression in size and liquid component of the cavity (*), with coil packing of the aneurysmal neck (white arrow).
See this image and copyright information in PMC

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