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