scholarly journals Systemic Artery-to-Pulmonary Artery Fistula Mimics Pulmonary Embolus

2019 ◽  
Vol 9 ◽  
pp. 41
Author(s):  
David Livingston ◽  
Matthew Grove ◽  
Rolf Grage ◽  
J. Mark McKinney
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Embolus ◽  
Lower Lobe ◽  
Filling Defect ◽  
Inferior Phrenic Artery ◽  
Arterial Blood ◽  
Systemic Artery ◽  
Phrenic Artery ◽  
The Right ◽  
Pulmonary Artery Fistula

Systemic artery-to-pulmonary artery fistula (SA-PAF) is a rare phenomenon that can resemble a filling defect on computed tomography angiography (CTA). SA-PAF can be due to congenital or acquired etiologies and can alter the hemodynamics of the pulmonary circulation, with the most serious reported complication being hemoptysis, requiring embolization. We describe a case of an unusual SA-PAF between the right inferior phrenic artery and the right lower lobe pulmonary artery that mimicked an unprovoked pulmonary embolus (PE) on standard CTA in a patient with cardiomyopathy. This SA-PAF was interpreted on CTA as PE due to the presence of a filling defect, revealing that not all filling defects are PE. SA-PAF should always be considered when the clinical context or the imaging findings are atypical, specifically with an isolated filling defect visualized in the inferior lower lobe pulmonary artery. The false-positive PE was the result of mixing of systemic non-opacified blood with opacified pulmonary arterial blood.

scholarly journals Systemic Artery to Pulmonary Artery Shunt Mimicking Acute Pulmonary Embolism, Unmasked by a Multimodality Imaging Approach

Tomography ◽  
2022 ◽  
Vol 8 (1) ◽  
pp. 175-179
Author(s):  
Brieg Dissaux ◽  
Pierre-Yves Le Floch ◽  
Romain Le Pennec ◽  
Cécile Tromeur ◽  
Pierre-Yves Le Roux
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Acute Pulmonary Embolism ◽  
Multimodality Imaging ◽  
Lower Lobe ◽  
Filling Defect ◽  
Pulmonary Angiography ◽  
Systemic Artery ◽  
Imaging Approach ◽  
The Right

In this report, we describe the functional imaging findings of systemic artery to pulmonary artery shunt in V/Q SPECT CT imaging. A 63-year-old man with small-cell lung cancer underwent CT pulmonary angiography (CTPA) for suspected acute pulmonary embolism (PE). The CTPA showed an isolated segmental filling defect in the right lower lobe, which was initially interpreted as positive for PE but was actually the consequence of a systemic artery to pulmonary artery shunt due to the recruitment of the bronchial arterial network by the adjacent tumor. A V/Q SPECT/CT scan was also performed, demonstrating a matched perfusion/ventilation defect in the right lower lobe.

scholarly journals Transcatheter Embolization of Systemic-to-pulmonary Artery Fistulas: a Case Report

2021 ◽  
Author(s):  
Shen Zhang ◽  
Jun Qian
Keyword(s):  
Pulmonary Artery ◽  
Arterial Embolization ◽  
Lung Parenchyma ◽  
Transcatheter Embolization ◽  
Bronchial Arteries ◽  
Pulmonary Vessel ◽  
Inferior Phrenic Artery ◽  
Systemic Artery ◽  
Phrenic Artery ◽  
Pulmonary Artery Fistula

Abstract The systemic artery to pulmonary vessel fistula(SAPVF) is an uncommon vascular abnormal communication between systemic arteries (except bronchial arteries) and the lung parenchyma[1]. It can be divided into congenital and acquired causes. Congenital SAPVF is often accompanied by cardiac or pulmonary artery hypoplasia, and acquired are usually caused by pleural adhesions after pleurisy, empyema, trauma, or surgery[2].We report a case of transcatheter arterial embolization for the treatment of congenital right inferior phrenic artery to pulmonary artery fistula.

scholarly journals Intralobar pulmonary sequestrations in adults

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Lower Lobe ◽  
Pulmonary Sequestration ◽  
Military Hospital ◽  
Lateral Side ◽  
Intralobar Sequestration ◽  
Arterial Blood ◽  
Systemic Artery ◽  
Clinical Presentations ◽  
Chest X Ray ◽  
The Right

Intralobar sequestration accounts for 75% of pulmonary sequestrations. It is characterized by the presence of nonfunctional parenchymal lung tissue, receiving systemic arterial blood supply. We conducted a retrospective medical records review of all patients evaluated and treated in our pulmonary department of military hospital of Tunisia with diagnosis of PS from January 2007 through December 2015. Among them, we report 5 cases of intralobar pulmonary sequestrations operated. There are three women and two men; the mean age is 27.6 years. The sequestration was intralobar in all cases. Clinical presentations were chest pain and productive cough in three cases. Chest X-ray showed left basal opacity in three cases, bilateral basal reticulonodular opacities in one case and round hydric opacity in the right lower lobe in one other case. Computed tomography was performed and revealed an aberrant systemic artery born from the lateral side of aorta supplying a left lower lobe sequestration in four cases and a right lower lobe mass in only one case. The confirmation was operative in all cases and histologic only in three cases. All patients were treated by lobectomy. Only one case presented with a pulmonary sequestration combined with tuberculosis and he was treated firstly by antituberculous chemotherapy. The results were excellent with a favorable clinical course and the mortality was nil.

scholarly journals A Rare Pulmonary Arterio-venous Malformation with Circular Shunting Due to Inferior Phrenic Artery Supply with Pulmonary Venous Drainage: a Case Report

2021 ◽  
Vol 3 (2) ◽  
pp. 688-691
Author(s):  
James Whiteley Dobson ◽  
Edem Barnor-Ahiaku ◽  
Sapna Puppala ◽  
Simon John McPherson
Keyword(s):  
Venous Malformation ◽  
Lower Lobe ◽  
Venous Drainage ◽  
Inferior Phrenic Artery ◽  
Arterial Circulation ◽  
Venous Circulation ◽  
Systemic Artery ◽  
Phrenic Artery ◽  
Arterio Venous Malformation ◽  
Systemic Arterial Supply

AbstractA rare case of a pulmonary arterio-venous malformation not requiring treatment is reported. An incidental peripheral right lower lobe intrapulmonary pulmonary arterio-venous malformation was identified on computed tomography. On catheter angiography, no pulmonary artery supply was identified. Systemic artery catheter arteriography identified systemic arterial supply from a conjoined inferior phrenic artery with pulmonary venous drainage to the left atrium. Due to this lung abnormality being a systemic arterial circulation to pulmonary venous circulation (left to left or circular) shunt, no treatment was indicated.

scholarly journals Bronchial Artery to Pulmonary Artery Fistula Presenting with Massive Hemoptysis in a Pediatric Patient

2021 ◽  
Author(s):  
Aoife Corcoran ◽  
Silvia Cardenas
Keyword(s):  
Pulmonary Artery ◽  
Bronchial Artery ◽  
Pulmonary Arteries ◽  
Lower Lobe ◽  
Massive Hemoptysis ◽  
Recurrent Bleeding ◽  
Moderate Volume ◽  
The Right ◽  
Pulmonary Artery Fistula ◽  
Right Bronchial Artery

Hemoptysis is a serious and potentially life-threatening event. Mortality is estimated at 13% for this chief complaint with age, volume of hemoptysis and receipt of blood products as risk factors for mortality. Hemoptysis is mostly seen in those with underlying congenital cardiac conditions or Cystic Fibrosis. We describe a unique case of a previously healthy 10 year old male who presented to the ED by EMS with a moderate volume episode of hemoptysis. He was admitted to the PICU where a sudden episode of massive hemoptysis precipitated by forced respiratory effort occurred during his examination. He decompensated and was emergently brought to the OR for airway evaluation by ENT and pulmonology. A large clot was found in the RML segment with brisk bleeding following removal of the clot. A 5 Fr bronchial blocker was placed to achieve hemostasis. Bronchial artery angiogram by IR demonstrated extravasation of contrast from right bronchial artery to segmental right lower lobe pulmonary artery shunt. He underwent embolization of the right bronchial artery. He was extubated the following day after no recurrent bleeding was confirmed with bronchoscopy. BA-PA fistulas are rare vascular anomalies in which an anastomosis is formed between systemic and pulmonary arteries. They are most commonly acquired, often described as secondary to chronic inflammatory lung diseases. BA-PA fistulas can also be congenital and have been seldom described in the literature. Our case highlights the importance of this rare diagnosis, which must remain on a pediatric pulmonologist’s differential due to the significant associated mortality.

scholarly journals Systemic artery: pulmonary artery fistula after closed chest cardiac massage.

BMJ ◽  
1976 ◽  
Vol 1 (6019) ◽  
pp. 1190-1190 ◽  
Author(s):  
M W Stannard ◽  
D J Delany ◽  
G F Murray
Keyword(s):  
Pulmonary Artery ◽  
Cardiac Massage ◽  
Closed Chest ◽  
Systemic Artery ◽  
Pulmonary Artery Fistula
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