Pulmonary artery aneurysms: diagnosis & endovascular therapy

Aneurysms and pseudoaneurysms are rare abnormalities of the pulmonary arteries. While their incidence is low, they represent potentially life-threatening conditions and can present a challenge for prompt diagnosis and treatment. An aneurysm of the pulmonary artery is defined as focal dilatation beyond maximum normal diameter (1). On computed tomography, a normal adult main pulmonary artery measures up to 29 mm in diameter and an interlobar pulmonary artery, 17 mm. A true aneurysm is defined as focal dilatation of an artery involving all three layers of the vascular wall—tunica intima, tunica media, and tunica adventitia. A pseudoaneurysm, by contrast, does not involve all three layers and thus poses a higher risk of rupture. A pulmonary artery pseudoaneurysm (PAPA) is a rare and potentially life-threatening disease characterized by focal saccular outpouching of a pulmonary artery representing a contained rupture of that artery (2). The mortality rate associated with the rupture of a pulmonary artery aneurysm (PAA) or PAPA has been reported from 50–100%; death is secondary to aspiration and asphyxia after intrapulmonary hemorrhage (3-6). PAA can also lead to dissection of the pulmonary artery and sudden cardiac death (2,7). Therefore, early diagnosis and treatment are critical for patient survival and optimal outcomes