Percutaneous Stent-Graft Repair of a Mycotic Pulmonary Artery Pseudoaneurysm |
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Authors: | Mei-chun Chou Huei-Lung Liang Huay-Ban Pan Chien-Fang Yang |
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Institution: | (1) Department of Radiology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan;(2) National Yang-Ming Medical University, Taipei, Taiwan |
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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. |
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Keywords: | Pseudoaneurysm Pulmonary artery Stent-graft |
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