Tuberc Respir Dis.  2009 Apr;66(4):319-323.

Successful Embolization in the Patient with Hemoptysis Due to Right Inferior Phrenic Artery-pulmonary Artery Anastomosis and Pseudoaneurysm

• Park HW
• Lee GE
• Park YS
• Son JW
• Choi EG
• Na MJ
• Kwon SJ

Abstract

The primary cause of hemoptysis is the bronchial artery. However, it should be noted that pulmonary artery and other vessels can cause hemoptysis. If the source of the bleeding is not determined after embolization, other evaluations are needed. Systemic-pulmonary anastomosis and pulmonary artery pseudo-aneurysm are rare vascular abnormalities with varying etiologies. An accurate and rapid diagnosis is needed in hemoptysis, since the cause may be life-threatening. We report a case of a 77-years-old man with persistent hemoptysis due to the right inferior phrenic artery - pulmonary artery anastomosis and pseudoaneurysm. After the embolization of the inferior phrenic artery, the hemoptysis was successfully treated.

Keyword

False Aneurysm; Hemoptysis; Embolization

MeSH Terms

Aneurysm, False
Arteries
Bronchial Arteries
Hemoptysis
Hemorrhage
Humans
Pulmonary Artery

Figure

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  Figure 1 (A) Initial chest X-ray at admission shows haziness in right lower lung. (B) Chest CT scan shows consolidation and ground glass opacity with 1.5 cm size, well marginated enhancing nodule in right lower lung.

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  Figure 2 (A) Right bronchial angiogram, active bleeding (arrow) from branch of right lower bronchial artery are shown. (B) Bronchial artery embolization was done using the contour particle.

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  Figure 3 (A) Inferior phrenic angiogram shows a pseudoaneurysm arising (arrow) from the right inferior phrenic artery shunting to right pulmonary artery. (B) After embolization with contour particle at distal part of right inferior phrenic artery, there was no more bleeding.

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  Figure 4 Disappeared pseudoaneurysm of right lower lobe in chest CT scan at 10 days after embolization.

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