Endovascular Embolization of Pulmonary Artery Pseudoaneurysms

Purpose: Pulmonary artery pseudoaneurysms are rare but serious vascular abnormalities which may lead to fatal  hemoptysis . This study reports  our experience of managing such pseudoaneurysms via endovascular embolization

Materials and Methods: Data of  patients who underwent Endovascular embolization for pulmonary artery pseudoaneurysms in our department from January 2014 to June 2024 was retrospectively analysed. Patient demographics,clinical condition,underlying pathology, lobe involved, number and size of pseudo-aneurysms and embolising  agent used were analysed.Technical and clinical outcomes as well as complications were studied.

Results: Twenty five pseudoaneurysms in twenty-five patients(16 males and 9 females) were treated with mean age of 45.4 years.The most common underlying ethology was tuberculosis seen in 15 patients (60%).Bacterial pneumonia was etiology in 5(20%) and fungal pneumonia in 3(12%). One patient had covid-19 associated mucormycois and in one patient no cause could be identified.Most common location of pseduaoaneurysms was bilateral upper lobes (32% each). Size of the pseudoaneurysms varied from 3mm to 36mm.Embolization was done using microcoils in 19(76%) patients and with glue in 7 (24%)patients .Technical success was achieved in 25(100% )patients where as clinical success was achieved in 24(96%).One patient had persistent hemoptysis after embolization and underwent surgery. No complications were encountered in any of the patients.

Conclusion: Pulmonary pseudoaneurysms though uncommon ,can be a cause of fatal hemoptysis.Endovascular embolization is minimally invasive and safe treatment option with minimal complication and recurrence rates