CardioVascular and Interventional Radiology

, Volume 29, Issue 5, pp 890–892 | Cite as

Percutaneous Stent-Graft Repair of a Mycotic Pulmonary Artery Pseudoaneurysm

  • Mei-chun Chou
  • Huei-Lung Liang
  • Huay-Ban Pan
  • Chien-Fang Yang
Article

Abstract

Ruptured mycotic pulmonary pseudoaneurysm is a lethal complication. Emergent surgical repair is usually recommended, but still associated with a high mortality rate. We present a patient in whom mycotic pulmonary pseudoaneurysm was a complication after surgical lobectomy 2 weeks earlier. This patient had suffered from repeated massive hemoptysis. After emergent surgical repair of the ruptured pulmonary artery stump, another episode of massive hemorrhage occurred. The pulmonary arteriogram revealed a segmental stenosis and a large, wide-necked, lobulated pseudoaneurysm at the left proximal pulmonary artery. We deployed a balloon-expandable stent-graft (48 mm in length mounted on a 12 mm × 40 mm angioplasty balloon) across the stenotic segment and the neck of the pulmonary pseudoaneurysm. Hemostasis was achieved immediately and, under a 4-week antibiotic treatment, patient was transferred to a local hospital for medical care. This case report demonstrates the benefit of minimally invasive endovascular therapy in a critically ill patient. A literature review of the etiology and management of mycotic pulmonary pseudoaneurysm is included.

Keywords

Pseudoaneurysm Pulmonary artery Stent-graft 

References

  1. 1.
    Charton RW, Du Plessis LA (1961) Multiple pulmonary artery aneurysms. Thorax 16:364–371CrossRefGoogle Scholar
  2. 2.
    Bozkurt AK, Öztunç F, Akman C, et al (2003) Multiple pulmonary artery aneurysms due to infective endocarditis. Ann Thorac Surg 75:593–596CrossRefPubMedGoogle Scholar
  3. 3.
    Merlino J, Temes T, Joste NE, et al (2003) Invasive pulmonary mucormycosis with ruptured pseudoaneurysm. Ann Thorac Surg 5:1332CrossRefGoogle Scholar
  4. 4.
    Miller JA (1993) Pulmonary mucormycosis. Chest Surg Clin North Am 3:699–705Google Scholar
  5. 5.
    Boulden TF, Tonkin IL, Burton EM, et al (1990) Mycotic pseudoaneurysm and thrombosis of modified left Blalock-Taussig shunt. Radiographics 10:119–121CrossRefPubMedGoogle Scholar
  6. 6.
    Subin K, Mainwaring RD, Lamberti JJ, et al (1994) Management of mycotic aneurysm following repair of corrected transposition. J Cardiac Surg 9:55–60CrossRefGoogle Scholar
  7. 7.
    SanDretto MA, Dcsnlom GT (1984) Multiple mycotic pulmonary artery aneurysms secondary to intravenous drug abuse. AJR Am J Roentgenol 142:89–90CrossRefPubMedGoogle Scholar
  8. 8.
    Wilson N, McLeod K, Hallworth D (2000) Images in cardiology. Exclusion of a pulmonary artery aneurysm using a covered stent. Heart 83:438CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Hannan RL, Miyaji K, Burke RP, et al (2001) Endovascular stent graft treatment of a pulmonary artery pseudoaneurysm. Ann Thorac Surg 71:727–729CrossRefPubMedGoogle Scholar
  10. 10.
    Poplausky MR, Rozenblit G, Rundback JH, et al (2001) Swan-Ganz catheter-induced pulmonary artery pseudoaneurysm formation. Three case reports and a review of the literature. Chest 120:2105–2111CrossRefPubMedGoogle Scholar
  11. 11.
    Semba CP, Sakai T, Slonim SM, et al (1998) Mycotic aneurysms of the thoracic aorta: Repair with use of endovascular stent-grafts. J Vasc Interv Radiol 9:33–40CrossRefPubMedGoogle Scholar
  12. 12.
    Kwon K, Choi D, Choi SH, et al (2002) Percutaneous stent-graft repair of mycotic common femoral artery aneurysm. J Endovasc Ther 9:690–693CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Mei-chun Chou
    • 1
    • 2
  • Huei-Lung Liang
    • 1
    • 2
  • Huay-Ban Pan
    • 1
    • 2
  • Chien-Fang Yang
    • 1
    • 2
  1. 1.Department of RadiologyKaohsiung Veterans General HospitalKaohsiungTaiwan
  2. 2.National Yang-Ming Medical UniversityTaipeiTaiwan

Personalised recommendations