case_images: PMC9479504_01
case_images: A 20-year-old female presented with chronic shortness of breath and nonspecific chest pain. (A) Posterior view of Tc99m MAA lung perfusion scan shows right basal perfusion defect (arrow).
case_images: JCIS-12-36-g001.jpg
case_images: PMC9479504_01_JCIS-12-36-g001.jpg
case_images: F1
case_images: CT chest angiography showed no evidence of pulmonary embolism; however, there was an incidental finding of anomalous systemic arterial supply from the abdominal aorta to the right base with a large vein draining into the pulmonary veins with no associated parenchymal abnormalities [Figure 1b]. Pulmonary angiography showed no arterial supply to the right base [Figure 1c]. The right phrenic artery was super selectively cannulated with a Lantern microcatheter (Penumbra Inc, CA, USA) [Figures 1d and e].
case_images: PMC9479504_02
case_images: A 20-year-old female presented with chronic shortness of breath and nonspecific chest pain. (B) Axial CT scan of the lower chest shows prominent right phrenic artery (arrow) supplying the right lung base.
case_images: JCIS-12-36-g002.jpg
case_images: PMC9479504_02_JCIS-12-36-g002.jpg
case_images: F2
case_images: Chest CT angiography showed anomalous phrenic artery coursing into the right lower lobe with draining vein into the pulmonary circulation in keeping with intralobar sequestration without associated parenchymal abnormalities [Figure 2a]. Initial aortography showed aberrant arterial supply to the right lung base through the right phrenic and venous drainage through the right pulmonary vein [Figures 2b to d]. Embolization for the right phrenic artery and its two branches was done using RUBY coils (Penumbra Inc, CA, USA) of variable diameters, and the main phrenic trunk was embolized with 6 mm Amplatzer Plug 4 (Abbott, MN, USA) [Figure 2e].