Embolization of multiple Rasmussen aneurysms as a treatment of hemoptysis

A 40-year-old man with a history of tuberculosis developed massive hemoptysis. Embolization of a bronchial artery branch did not resolve the bleeding. Selective angiography eventually revealed three pseudoaneurysms arising from an apical segmental branch of the right pulmonary artery, two of which were successfully embolized with coils. The patient's hemoptysis resolved within 48 hours. Although most patients with hemoptysis and active tuberculosis bleed from the bronchial circulation, the pulmonary arterial circulation should be immediately evaluated if the bronchial angiogram is normal. Coil embolization is a safe and effective means of treating these pseudoaneurysms.