Pulmonary
vascular injury is a rare but life-threatening complication of Swan-Ganz catheterization. We report an 82-year old patient who underwent right heart catheterization by a balloon-tipped
catheter because of suspected
pulmonary hypertension. After deflation of the
catheter in the wedge position, hemoptoe appeared associated with acute
respiratory insufficiency requiring respiratory support by intubation and
mechanical ventilation. Pulmonary angiography showed the formation of a
false aneurysm of a segment artery of the left lower lobe. Immediate interventional
therapy was performed by the implantation of two coated coronary
stent grafts into the injured pulmonary artery thereby excluding the
false aneurysm.
Bleeding was stopped by this interventional approach while antegrade blood flow was maintained. Long term follow-up after 3 months showed an effective treatment with a completely thrombotic
false aneurysm. However, despite oral anticoagulation and dual antiplatelet
therapy, graft patency could not be achieved after 3 months. In summary, implantation of coated
stents is a feasible and safe approach for the acute and long term treatment of potentially life-threatening condition of a pulmonary artery
false aneurysm while treatment to achieve long term patency of the affected vessel still remains an issue to be resolved.