Iatrogenic pulmonary artery pseudoaneurysm

Swan Ganz catheter induced pulmonary

artery Pseudoaneurysm

Dr. Ibdah RasheedTuebingen 29.07.2013

Rupture of pulmonary artery with Swan Ganz catheter placement reported about 0.4 of cases

Causes may include: - inflation in peripheral pulmonary artery - hyperinflation of ballon - vigorous flushing

General Considerations

Risk factors:

- age over 65 - anticoagulation Therapy - pulmonary artery hypertention - chronic steroid use

Hemoptysis : massive, mild early or delay onset( up to 2 weeks) Asymptomatic (most common,

underestimated)

Clinical findings:

CT-angio:

- an enhancing mass adjacent to a vessel - dense nodule with halo of fainter density

Angiography ( gold standard)

- Extravascular collection arising from a vessel

Image findings:

Watch and wait strategy Transcatheter coil embolization is the

treatment of choiceThrombin injection ,new approach ,high

success rate Emergency surgical options ( in massive

bleeding) ,no mortality benefits: - ligation of pulmonary artery - Lobetomy

Treatment

Thanks