Ultrasonographically guided percutaneous embolization of a pulmonary pseudoaneurysm

Pulmonary pseudoaneurysms have been described as an unusual complication of Swan-Ganz catheter placement, tuberculosis, bronchiectasis, aspergillomas, and pulmonary hypertension. Untreated, they may lead to life-threatening hemorrhage. Coil embolization to occlude the pseudoaneurysms is the treatment of choice. This report describes a case in which a pulmonary pseudoaneurysm that likely resulted from the previous use of a Swan-Ganz catheter was identified but in which angiography failed to demonstrate a feeding vessel. The pseudoaneurysm was visible by transthoracic ultrasonography because it was surrounded by consolidated lung, possibly related to hemorrhage. Ultrasonography was used to guide puncture of the pseudoaneurysm, and percutaneous coil embolization was performed subsequently. Subsequent angiography and computed tomography demonstrated successful occlusion of the aneurysm. This case illustrates the utility of percutaneous management of pulmonary pseudoaneurysms in certain cases.