Treatment of a Post-biopsy Pulmonary Artery Pseudoaneurysm

Peripheral pulmonary artery pseudoaneurysms (PPAP) following a lung biopsy are exceedingly rare but can lead to severe haemoptysis. Cases requiring treatment are usually managed using an endovascular approach. Nevertheless, successful percutaneous treatment has been described. Several embolic agents can be used to accomplish percutaneous embolization. We aim to report a successful percutaneous treatment of a post-biopsy PPAP using thrombin. Our patient developed a PPAP, with consequent large alveolar haemorrhage and haemoptysis, after a transthoracic lung biopsy. Because the patient had a mechanical mitral valve, she needed to be anticoagulated, impairing the spontaneous resolution of the pseudoaneurysm. Therefore, the PPAP had to be treated to safely anticoagulate the patient. A percutaneous approach was chosen given the very peripheric location of the PPAP. Treating PPAP with an endovascular approach can be challenging. With this report, we demonstrate that the percutaneous approach is a safe and efficient alternative method. We choose thrombin as an embolic agent given its safety profile and efficacy under anticoagulation. The good results of our intervention reinforce the applicability and efficacy of this kind of treatment approach to PPAP.