Pulmonary arterial aneurysm
Updates to Article Attributes
Pulmonary arterial aneurysms (PAAs) refer to a focal dilatation of the pulmonary arterial system.
Epidemiology
Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 4-5.
Pathology
A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms affect the main pulmonary arteries 4.
Aetiology
They can arise from a number of congenital as well as acquired pathologies (the latter is considered more common):
-
acquired
- trauma
- iatrogenic, e.g. catheterisation
- blunt or penetrating injuries (often pseudoaneurysm)
- infection:
- mycotic aneurysm in IV drug users
- syphilis
- tuberculosis: Rasmussen aneurysm
- idiopathic 4
- acquired causes leading to pulmonary hypertension 3 orcystic medial degeneration
- trauma
-
congenital
- congenital cardiac anomalies leading to pulmonary arterial hypertension - patent ductus arteriosus is the most common cause
- increased flow due to left to right shunts
- increased haemodynamic shear stresses
- pulmonary valvular and postvalvular stenosis
- certain pulmonary vasculitides
- congenital cardiac anomalies leading to pulmonary arterial hypertension - patent ductus arteriosus is the most common cause
Radiographic features
Plain radiograph
Radiographic features are non-specific and they may appear as hilar enlargement or a lung nodule.
CT
CT angiography (CTA) allows much better appreciation of anatomy. Some consider the upper limit of normal diameter of the pulmonary trunk on CT scan to be 29 mm and the right interlobar artery to be 17 mm 1.
See also
-<p><strong>Pulmonary arterial aneurysms (PAAs)</strong> refer to a focal dilatation of the pulmonary arterial system.</p><h4>Epidemiology</h4><p>Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 <sup>4-5</sup>.</p><h4>Pathology</h4><p>A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms affect the main pulmonary arteries <sup>4</sup>.</p><h5>Aetiology</h5><p>They can arise from a number of congenital as well as acquired pathologies (the latter is considered more common):</p><ul>- +<p><strong>Pulmonary arterial aneurysms</strong> refer to a focal dilatation of the pulmonary arterial system.</p><h4>Epidemiology</h4><p>Overall it is considered a rare entity with autopsy prevalence rates of around 1 in 14,000 to 100,000 <sup>4-5</sup>.</p><h4>Pathology</h4><p>A true pulmonary artery aneurysm results from dilatation of all three layers of the vessel wall while a pulmonary artery pseudoaneurysm does not involve all layers of the arterial wall. Most of the aneurysms affect the main pulmonary arteries <sup>4</sup>.</p><h5>Aetiology</h5><p>They can arise from a number of congenital as well as acquired pathologies (the latter is considered more common):</p><ul>
-<li>congenital cardiac anomalies leading to pulmonary arterial hypertension - <a title="Patent ductus arteriosus" href="/articles/patent-ductus-arteriosus">patent ductus arteriosus</a> is the most common cause<ul>- +<li>congenital cardiac anomalies leading to pulmonary arterial hypertension - <a href="/articles/patent-ductus-arteriosus">patent ductus arteriosus</a> is the most common cause<ul>
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