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All Journal International Journal of Radiology and Imaging
Dini R. Erawati
Department of Radiology, Medical Faculty, University of Brawijaya, RSUD Dr. Saiful Anwar
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Medicine & Pharmacology Neuroscience

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THE ROLE OF CHEST CT ANGIOGRAPHY AS A DIAGNOSTIC TOOL AND ROAD MAP FOR THE MANAGEMENT OF RASMUSSEN’S ANEURYSM: A CASE REPORT Maskuril Barkah Barkah; Dini R. Erawati; Ahmad Bayhaqi Nasir Aslam; Agung Setyawan; Ricardo Tjakraatmadja
International Journal of Radiology and Imaging Vol. 1 No. 02 (2022): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (586.66 KB) | DOI: 10.21776/ub.ijri.2022.001.02.4

Abstract

Rasmussen’s aneurysm is a pulmonary artery pseudoaneurysm, secondary to the invasion of granular tissues to the pulmonary artery wall, causing massive hemoptysis. A 39-year-old male, with a history of pulmonary TB presented with massive hemoptysis, persistent cough, and dyspnea. Chest X-ray and Chest CT depicted active pulmonary tuberculosis and a co-infection with aspergillosis in the form of aspergilloma. Chest CT angiography (CTA) showed narrow-necked Rasmussen’s aneurysm with the feeding artery coming from the pulmonary artery of the apicoposterior segment and the systemic artery from the left thyrocervical trunk branch and left bronchial artery. Fluoroscopy-guided transarterial embolization with polyvinyl alcohol (PVA) and gel foam was performed from the left bronchial artery and thyrocervical trunk branch followed by transcatheter embolization with glue insertion via the pulmonary artery in the aneurysmal site. After the procedures the embolic agent completely filled the aneurysm and there were no complaints of hemoptysis during the follow-up. Appropriate chest CT angiography procedures can help diagnose Rasmussen’s aneurysm and become a road map for embolization. Transarterial catheter embolization from bronchial or non-bronchial systemic artery and pulmonary artery can be used as the treatment modality of choice for Rasmussen’s aneurysm in pulmonary tuberculosis with aspergillosis co-infection in the form of aspergilloma.
Co-Authors Agung Setyawan Ahmad Bayhaqi Nasir Aslam Maskuril Barkah Barkah Ricardo Tjakraatmadja