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Swan-Ganz Catheter-Induced Pulmonary Artery Pseudoaneurysm Formation

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Presentation on theme: "Swan-Ganz Catheter-Induced Pulmonary Artery Pseudoaneurysm Formation"— Presentation transcript:

1 Swan-Ganz Catheter-Induced Pulmonary Artery Pseudoaneurysm Formation
Maurice R. Poplausky, MD, Grigory Rozenblit, MD, John H. Rundback, MD, Gastone Crea, MD, Shekher Maddineni, MD, Robert Leonardo, MD  CHEST  Volume 120, Issue 6, Pages (December 2001) DOI: /chest Copyright © 2001 The American College of Chest Physicians Terms and Conditions

2 Figure 1 A portable chest radiograph demonstrating the right jugular vein Swan-Ganz catheter tip to be wedged in a right lower lobe PA (white arrow). CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

3 Figure 2 Image from a right PA angiogram (top) showing a faint extravascular collection (arrows) adjacent to the right lower lobe PA. The pseudoaneurysm is visualized much better after a selective catheterization arteriogram of the pseudoaneurysm (bottom). CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

4 Figure 3 Postembolization digital subtraction angiography demonstrates complete occlusion of the pseudoaneurysm with sparing of the feeding vessel. The subtracted images of the coils within the pseudoaneurysm are easily seen (arrow). CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

5 Figure 4 Chest radiograph (top) and CT scan of the chest (middle and bottom) performed after embolization demonstrate an effusion (open arrow) and atelectasis (arrow heads) of the right lower lobe. The coils in the pseudoaneurysm are easily identified (curved arrows). CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

6 Figure 5 A chest radiograph performed 2 months after embolization shows the coils to be present (arrow) with complete resolution of the atelectasis and effusion. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

7 Figure 6 An anterior-posterior portable chest radiograph demonstrating a new, right upper lobe, circumscribed infiltrate (large arrows) in a patient with a Swan-Ganz catheter (small arrows). CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

8 Figure 7 Early (top) and late (bottom) subtracted images of a right PA angiogram demonstrating an upper lobe PA pseudoaneurysm (arrow). The visceral pleural edge (open arrows) has been displaced from the chest wall (small arrows) by a large effusion. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

9 Figure 8 A selective arteriogram of the feeding vessel demonstrates the pseudoaneurysm to be at the epicenter of the new infiltrate. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

10 Figure 9 A postembolization right PA angiogram showing nonfilling of the coiled pseudoaneurysm. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

11 Figure 10 Coils are seen in the middle of the infiltrate (arrows) on a postembolization chest radiograph. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions

12 Figure 11 A right PA arteriogram (top) demonstrating a pseudoaneurysm (arrows) arising from the right middle lobe PA. A postembolization image (bottom) shows a partial occlusion of the pseudoaneurysm. CHEST  , DOI: ( /chest ) Copyright © 2001 The American College of Chest Physicians Terms and Conditions


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