Update on the previous case: Fig. 1 is an SMA #Angiography t | Figure 1

CrazyJona

Update on the previous case:

Fig. 1 is an SMA #Angiography that shows (orange arrow) a small #Pseudoaneurysm arising from the distal portion of first ileal branch. After #Catheterization a "sandwich" technique coil #Embolization was performed. Fig. 2 shows persistence of flow into the #Pseudoaneurysm. After more coils, Fig. 3 shows control Angio run with exclusion of the #Pseudoaneurysm and preserved distal flow through collaterals.

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Question 1: True/ False
Coil erosion has been classically described in pseudoaneurysms and aneurysms.
Question 2: Where should coils be deployed in a pseudoaneurysm? (choose all that apply).
A. Proximal to pseudoaneurysm
B. At the pseudoaneurysm
C. Distal to pseudoaneurysm
Admission EGD following preparation is shown in Images 2 and 3.
Question 3: What do images 2 and 3 reveal?

Contrast enhanced CT is shown in Image 4.
Question 4: What do you see in image 4?
After consultation, IR accepts this patient; next time, find out how they intervened.
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Follow up Answers:
Q1: CTA demonstrated right pulmonary artery pseudoaneurysm with 2 efferent #vessels.
Q2: The most common overall cause of pulmonary #artery #pseudoaneurysm in the US is iatrogenic. Additional causes include neoplastic, infectious or congenital etiologies.
Q3: The different treatment options depend on the anatomy, clinical picture and etiology of the pseudoaneurysm: #Embolization of the feeding vessel or pseudoaneurysm with particles or coils, endovascular stent graft placement, surgical ligation of involved pulmonary artery, wedge resection or lobectomy and watchful waiting are all options.
Patient was taken to the #IR suite.
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Fig 2 SA showing coil occlusion of superior efferent branch (star) and opacification of inferior efferent branch (arrow below)
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