Abstract
Pulmonary artery pseudoaneurysm (PAPA), an uncommon complication of pyogenic bacterial and fungal infections and related septic emboli, is associated with high mortality. The pulmonary artery (PA) lacks an adventitial wall; therefore, repeated endovascular seeding of the PA with septic emboli creates saccular dilations that are more likely to rupture than systemic arterial aneurysms. The most common clinical presentation of PAPA is massive hemoptysis and resultant worsening hypoxemia. Computed tomography angiography is the preferred diagnostic modality for PAPA; typical imaging patterns include focal outpouchings of contrast adjacent to a branch of the PA following the same contrast density as the PA in all phases of the study. In mycotic PAPAs, multiple synchronous lesions are often seen in segmental and subsegmental PAs due to ongoing embolic phenomena. The recommended approach for a mycotic PAPA is prolonged antimicrobial therapy; for massive hemoptysis, endovascular treatment (e.g., coil embolization, stenting, or embolization of the feeding vessel) is preferred. PAPA resection and lobectomy are a last resort, generally reserved for patients with uncontrolled hemoptysis or pleural hemorrhage. We present a case of a 28-year-...Continue Reading
References
Jun 1, 1992·The American Review of Respiratory Disease·M J CoffeyJ P Lynch
Nov 1, 1988·Chest·T BartterG Nash
Nov 1, 1994·Radiology·E D SantelliH A Thomas
Jun 2, 2000·Critical Care Medicine·E Jean-Baptiste
Mar 28, 2001·The Annals of Thoracic Surgery·C SavageG R Wittich
Sep 11, 2004·Journal of Intensive Care Medicine·Alexandre R AbreuBruce P Krieger
Mar 28, 2006·Cardiovascular and Interventional Radiology·Mei-Chun ChouChien-Fang Yang
Dec 23, 2006·Journal of Vascular and Interventional Radiology : JVIR·Christopher L Hovis, Phillip T Zeni
Jan 24, 2007·AJR. American Journal of Roentgenology·Elsie T NguyenNestor L Müller
Feb 28, 2007·Acta Radiologica·A Park, W Cwikiel
Jul 5, 2007·Journal of Vascular and Interventional Radiology : JVIR·Tae-Beom ShinChang-Won Kim
May 6, 2009·Cardiovascular and Interventional Radiology·Koichiro YamakadoKan Takeda
Oct 16, 2009·Interactive Cardiovascular and Thoracic Surgery·Achim KochMatthias Karck
Feb 18, 2010·Journal of Thoracic Imaging·José de Jesus CamargoRodrigo Moreira Bello
Jun 3, 2010·Interactive Cardiovascular and Thoracic Surgery·Yuki MatsumuraToru Sato
Jul 27, 2010·Radiology·Suyoung ShinYongjoo Kim
Nov 22, 2012·Seminars in Ultrasound, CT, and MR·Carlos S Restrepo, Aimee P Carswell
Sep 23, 2016·AJR. American Journal of Roentgenology·Ying ChenCarol C Wu
Citations
Aug 27, 2019·Journal of Pediatric Hematology/oncology·Tabinda N QureshiYasser Wali
Dec 8, 2019·BMJ Case Reports·Stefan LazicSiva Mahendran
Jul 9, 2021·BMJ Case Reports·Joseph Doyle, Peter Mhandu
Sep 2, 2021·Radiology Case Reports·Surabhi JajodiaMahesh Kumar Goenka