FALSE ANEURYSM OF THE PULMONARY-ARTERY INDUCED BY A SWAN-GANZ CATHETER - CLINICAL PRESENTATION AND RADIOLOGIC MANAGEMENT

OBJECTIVE. This study evaluates retrospectively the clinical presentat ion, radiographic findings, and angiographic management of false aneur ysm of the pulmonary artery resulting from Swan-Ganz catheter placemen t. MATERIALS AND METHODS. Over a 4-year period, seven false aneurysms of the pulmonary artery were diagnosed in five patients (four women, o ne man) who were 67-81 years old. All five patients underwent Swan-Gan z catheter placement to monitor cardiac surgery-coronary artery bypass grafting in four and mitral valve replacement in one. All patients we re anticoagulated. For five patients, we reviewed the medical records and the results of chest radiography, digital subtraction pulmonary an giography, and pulmonary artery embolization. For two patients, we rev iewed the results of CT scanning. RESULTS. Non-life-threatening hemopt ysis was noted in all cases and occurred in three patients after the S wan-Ganz catheter had been removed (elapsed time of 1-19 days). Chest radiographs revealed a pulmonary infiltrate in one patient and a pulmo nary 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 th rombosis. Pulmonary angiography revealed a single false aneurysm in th ree patients and two false aneurysms in two patients. All false aneury sms 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 ane urysm of the pulmonary artery after Swan-Ganz catheter placement requi re enhanced CT or pulmonary angiography to establish the diagnosis. Fa lse aneurysms of the pulmonary artery can be treated at the time of pu lmonary angiography by steel-coil embolization.