Percutaneous Closure of Bilateral Pulmonary Artery Aneurysms in Behcet's Disease

Abstract

Behcet's disease is a multisystemic vasculitis. It can affect the pulmonary artery in 2% to 5% cases. We discuss a case of a young male diagnosed with Behcet's disease on immunosuppressive therapy who presented with bilateral pulmonary artery aneurysms which were closed with covered stent and other devices.

Keywords: autoimmune; imaging; occluder; pulmonary circulation; stents; vascular disease.

Graphical abstract

Figure 1

Bilateral Perihilar Enlargements Suggestive of the Pulmonary Artery Aneurysms Arrows indicate the enlargements.

Figure 2

Chest Computed Tomography Scans (A, C) Left lower lobar branch of pulmonary artery (PA) with saccular aneurysm with partial thrombosis. (B, D) Pulmonary artery aneurysm (PAA) in right lower branch of PA. (E) three-dimensional reconstruction images of bilateral PAAs.

Figure 3

Left Pulmonary Angiogram Saccular aneurysm arising from the left interlobar artery with the mouth of the aneurysm measuring 27 mm and a proximal left interlobar artery diameter of 13 mm.

Figure 4

Vascular Stent A 13.5 × 40–mm fluency plus vascular stent graft (arrow) was placed across the left PA aneurysm and deployed. Abbreviation as in Figure 2.

Figure 5

Re-Check Angiogram After Stent Deployment Residual leak is shown at the distal end of the aneurysm.

Figure 6

Residual Leak Closure An 8/6 Lifetech Konar MFO device (red circle) was deployed at the lower end of the aneurysm to close the residual leak.

Figure 7

Final Left PA Angiogram Minimal residual flow into aneurysm is shown with unobstructed flow in the PA branches. Abbreviation as in Figure 2.

Figure 8

Right PA Angiogram A saccular aneurysm is shown arising from the lower lobar branch with the mouth of the aneurysm measuring 10 mm.

Figure 9

Patent Ductus Arteriosus Device Deployment A 16/14 Occlunix patent ductus arteriosus device (arrow) was used to close the right-sided PAA. Abbreviation as in Figure 2.

Figure 10

Final Right PA Angiogram The aneurysm was cut off successfully with no flow and unobstructed flow into right PA branches. Abbreviation as in Figure 2.