Medicina Intensiva Medicina Intensiva
Med Intensiva 2018;42:e11-2 - Vol. 42 Núm.5 DOI: 10.1016/j.medin.2017.04.004
Images in Intensive Medicine
Child with leukemia and symptomatic pulmonary pseudoaneurysm subjected to catheterization
Niño con leucemia y pseudoaneurisma pulmonar sintomático tratado por cateterismo
R.E. Ríos-Méndez, , M.L. Freire-Astudillo, M.E. Aráuz-Martínez
Hospital Pediátrico Baca Ortiz, Quito, Ecuador

A 12 year-old patient with non-suffocating hemoptysis, with a history of acute lymphoblastic leukemia receiving chemotheraphy and pneumonia a month earlier. Pulmonary CT showed a pulmonary artery pseudoaneurysm (PAP) (Fig. 1A). By femoral venous approach, we performed several angiographic projections (Fig. 1B) and implanted in the neck of the PAP an occluder device of ductus arteriosus, Amplatzer Duct Occluder™ (St. Jude Medical) 10×8, leaving initial minimal residual flow (Fig. 2A). At the sixth month the CT scan showed total occlusion of the PAP and permeability of the compromised pulmonary vessel (Fig. 2B). Hospital discharge: 48h. Follow-up: 18 months. The percutaneous treatment of PAP is safe and effective, and may prevent surgery that may require lobectomy.

Figure 1.
(0.15MB).

(A) Initial CT scan. 3D reconstruction showing the pulmonary artery pseudoaneurysm (arrow) in the right interlobar artery of 25×22mm with short neck and ostium of 7.8mm in diameter. (B) Initial Angiography. Extravasation of contrast of the eroded pulmonary artery pseudoaneurysm to pulmonary parenchyma (arrow).

Figure 2.
(0.1MB).

(A) Post-procedure angiography. Look at the permeability of the pulmonary vessels distal to the device (arrow). (B) Control CT scan (6th month). 3D reconstruction showing occlusion of pulmonary artery pseudoaneurysm (arrow).

Corresponding author. (R.E. Ríos-Méndez riosmendez@intramed.net.ar)
Copyright © 2017. Elsevier España, S.L.U. y SEMICYUC
Med Intensiva 2018;42:e11-2 - Vol. 42 Núm.5 DOI: 10.1016/j.medin.2017.04.004
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