Infectious Pulmonary Artery Pseudoaneurysm Secondary to a Lung Abscess Treated With Pulmonary Artery Coil Embolization: A Case Report

Murakami, Takumi; Otomo, Yutaro; Ito, Tatsuya; Sato, Kenjiro; Ohba, Takehiko

doi:10.7759/cureus.55762

Cited by 3 publications

References 17 publications

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Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study

Liu,

et al. 2024

BMC Pulm Med

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Background Hemoptysis resulting from rupture of the pulmonary artery pseudoaneurysm (PAP) is massive and fatal, while factor contributing to the rupture of pseudoaneurysm remains elusive. This study aimed to elucidate the clinical and radiological features of PAP and identify the risk factors associated with rupture. Methods Patients who developed hemoptysis with PAP were collected from January 2019 to December 2022 retrospectively. Clinical data of the demographic characteristics, radiological findings, treatment strategies, and prognosis were collected. A comparative analysis was performed on the characteristics in the ruptured and non-ruptured cases. Results A total of 58 PAPs were identified in the 50 patients. The most common causes were infection (86%) and cancer (8%). The PAPs were located predominantly in the upper lobes of both lungs, and 57 (99.3%) were distributed in the segmental or subsegmental pulmonary arteries. The median diameter was 6.1(4.3–8.7) mm. A total of 29 PAPs were identified adjacent to pulmonary cavitations, with the median diameter of the cavity being 18.9 (12.4–34.8) mm. Rupture of pseudoaneurysm occurred in 21 cases (42%). Compared to unruptured group, the ruptured group had a significantly higher proportion of massive hemoptysis (57.1% vs. 6.9%, p < 0.001), larger pseudoaneurysm diameter (8.1 ± 3.2 mm vs. 6.0 ± 2.3 mm, p = 0.012), higher incidence of pulmonary cavitation (76.2% vs. 44.8%, p = 0.027), and larger cavitation diameters (32.9 ± 18.8 mm vs. 15.7 ± 8.4 mm, p = 0.005). The mean pulmonary artery pressure (mPAP) in the ruptured group was also significantly higher than that in the unruptured group [23.9 ± 7.4 mmHg vs. 19.2 ± 5.0 mmHg, p = 0.011]. Endovascular treatment was successfully performed in all 21 patients with ruptured PAP, of which the clinical success rate was 96.0%. Five patients experienced recurrent hemoptysis within one year. Conclusions Massive hemoptysis, pseudoaneurysm diameter, pulmonary cavitation, and elevated mPAP were the risk factors for rupture of pseudoaneurysm. Our findings facilitate early identification and timely intervention of PAP at high risk of rupture.

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Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study

Liu,

et al. 2024

BMC Pulm Med

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Lung Abscess

Celik,

Atay

2024

Thoracic Infections

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Lung abscess is usually observed in patients with chronic disorders including impaired consciousness or immunosuppresants conditions that lead to repetitive aspiration attacks. The common site of involvement is apical segment of lower lobes. Fever, prolonged cough and foul-smelling sputum are frequent symptoms. Diagnosis is based on physical examination and acquiring detailed medical history that should be accompanied by radiologic studies that usually show mass appearance, air-fluid level or cavitation. Antibiotic therapy and respiratory rehabilitation with postural drainage are the mainstay of the therapy. However, patients who are unresponsive to medical approach may require percutaneous drainage or even surgical resection of the affected lobe. Prognosis of lung abscess is strongly related to persistence of abscess for more than two months, comorbidities such as malignancy, advanced age and size of the abscess.

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Mechanical Thrombectomy Complicated by Pulmonary Artery Pseudoaneurysm Treated With Endovascular Thrombin Injection

So,

Krauthamer

2024

Cureus

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Pulmonary thrombectomy for acute pulmonary arterial embolism has emerged as an effective endovascular therapy for high-risk patients. While the procedure is typically performed safely and efficaciously, given the nature of the treatment, complications may rarely occur. Pulmonary pseudoaneurysm is a rare condition occurring in a variety of settings, including pulmonary thrombectomy. To our knowledge, we present the first published case of pulmonary artery pseudoaneurysm following percutaneous thrombectomy, along with its successful endovascular management.

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Infectious Pulmonary Artery Pseudoaneurysm Secondary to a Lung Abscess Treated With Pulmonary Artery Coil Embolization: A Case Report

Cited by 3 publications

References 17 publications

Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study

Clinical and radiological features associated with rupture of pulmonary artery pseudoaneurysm: a retrospective study

Lung Abscess

Mechanical Thrombectomy Complicated by Pulmonary Artery Pseudoaneurysm Treated With Endovascular Thrombin Injection

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