case_images: PMC11788330_01
case_images: Abnormal branch angiography of the descending aorta. (A) Angiography of the four abnormal vessels before surgery. (B-E) Individual angiograms of the four abnormal vessels from head to foot. (F) Angiography of the four abnormal vessels after surgery.
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case_images: PMC11788330_01_fcvm-11-1518853-g001.jpg
case_images: F1
case_images: We found four malformed arterial vessels originating from the left posterior wall of the descending aorta at the level of the 7th-8th thoracic vertebrae supplying a pulmonary cyst (Figure 1A). A small portion of blood flow returned to the left atrium through collateral vessels into the pulmonary veins, while most flowed through the malformed vascular network, ascending along the abnormal venous vessels beside the spine to converge at the junction of the superior vena cava and the right atrium (Figure 1A). A COOK multipurpose (MPA) 5Fr catheter was guided along the super smooth guidewire into the malformed vessel, and the guidewire was withdrawn to perform angiography of the four malformed arteries (Figures 1A-E). Angiography of the descending aorta indicated complete occlusion of the four malformed vessels with no shunting observed, and the proximal end of the vascular plugs was located within the opening of the malformed arteries in the descending aorta (Figure 1F).
case_images: (A,B) Three-dimensional CT of the chest before surgery (marked in red for PS). (C,D) Three-dimensional CT of the chest 12 months after surgery.
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case_images: PMC11788330_01_fcvm-11-1518853-g002.jpg
case_images: F2
case_images: Comparing the preoperative CT (Figures 2A,B) with the follow-up CT at 12 months post-surgery, most of the abnormal lung tissue had been absorbed and regressed, with no significant vascular configuration in the non-regressed portions (Figures 2C,D).