American Journal of Roentgenology, Vol 167, 941-945, Copyright © 1996 by American Roentgen Ray Society

ARTICLES

False aneurysm of the pulmonary artery induced by a Swan-Ganz catheter: clinical presentation and radiologic management

GR Ferretti, F Thony, KM Link, M Durand, K Wollschlager, D Blin and M Coulomb
Department of Radiology, Hopital Michallon, CHU Grenoble, France.

OBJECTIVE: This study evaluates retrospectively the clinical presentation, radiographic findings, and angiographic management of false aneurysm of the pulmonary artery resulting from Swan-Ganz catheter placement. MATERIALS AND METHODS: Over a 4-year period, seven false aneurysms of the pulmonary artery were diagnosed in five patients (four women, one man) who were 67-81 years old. All five patients underwent Swan-Ganz catheter placement to monitor cardiac surgery-- coronary artery bypass grafting in four and mitral valve replacement in one. All patients were anticoagulated. For five patients, we reviewed the medical records and the results of chest radiography, digital subtraction pulmonary angiography, and pulmonary artery embolization. For two patients, we reviewed the results of CT scanning. RESULTS: Non- life-threatening hemoptysis was noted in all cases and occurred in three patients after the Swan-Ganz catheter had been removed (elapsed time of 1-19 days). Chest radiographs revealed a pulmonary infiltrate in one patient and a pulmonary mass in two patients. The results were unremarkable in the other two patients. CT depicted two false aneurysms of the pulmonary artery as round masses with eccentrically enhanced lumina circumscribed by thrombosis. Pulmonary angiography revealed a single false aneurysm in three patients and two false aneurysms in two patients. All false aneurysms were localized in segmental or subsegmental branches of the right middle pulmonary artery (n = 4) or the right lower pulmonary artery (n = 3). All patients were successfully treated with transcatheter steel-coil embolization. CONCLUSION: Even when the chest radiograph appears unremarkable, patients clinically suspected of developing a false aneurysm of the pulmonary artery after Swan-Ganz catheter placement require enhanced CT or pulmonary angiography to establish the diagnosis. False aneurysms of the pulmonary artery can be treated at the time of pulmonary angiography by steel-coil embolization.
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