Rasmussen's Aneurysm Research Articles

Rasmussen's Aneurysm: A Rare Cause of Massive Hemoptysis in Pulmonary Tuberculosis

Rasmussen's aneurysm is a rare cause of hemoptysis in patients with tuberculosis. It is an under-recognised vascular complication of active pulmonary tuberculosis, with a mortality rate of over 50%. It is secondary to an aneurysmal dilatation of the pulmonary artery adjacent to tuberculous cavity. Thoracic CT angiography is the gold standard for making a positive diagnosis and precising the hemorrhagic site, with a mapping of the pulmonary artery damage. Rupture of the artery can cause massive hemoptysis, which can sometimes be devastating. It is important to remember that hemoptysis persists despite successful bronchial artery embolisation in all patients with tuberculosis.

Percutaneous Approach for a Rasmussen Aneurysm

Percutaneous Approach for a Rasmussen Aneurysm

A case of multiple Rasmussen's aneurysm.

A case of multiple Rasmussen's aneurysm.

Hydatid Disease: A Radiological Pictorial Review of a Great Neoplasms Mimicker

Hydatid cyst is a common name for the larval stage of a tapeworm species of Echinococcus granulosus, which is transmitted from animals to humans via the fecal-oral route. Hydatid cysts predominantly affect the liver (75%), followed by the lung (15%), and they can affect many organs in the human body. Medical imaging modalities are the keystone for the diagnosis of hydatid cysts with high sensitivity and specificity. Ultrasound imaging with high resolution is the first choice for diagnosis, differential diagnosis, staging, establishing a role in interventional management, and follow-up, and it can differentiate Type I hydatid cysts from simple liver cysts. Unenhanced computed tomography (CT) is indicated where or when an ultrasound is unsatisfactory, such as with chest or brain hydatid cysts, when detecting calcification, and in obese patients. Magnetic resonance imaging (MRI) is superior for demonstrating cyst wall defects, biliary communication, neural involvement, and differentiating hydatid cysts from simple cysts using diffusion-weighted imaging (DWI) sequences. According to the phase of growth, hydatid cysts occur in different sizes and shapes, which may mimic benign or malignant neoplasms and may create diagnostic challenges in some cases. Hydatid cysts can mimic simple cysts, choledochal cysts, Caroli's disease, or mesenchymal hamartomas of the liver. They can mimic lung cystic lesions, mycetoma, blood clots, Rasmussen aneurysms, and even lung carcinomas. Differential diagnosis can be difficult for arachnoid cysts, porencephalic cysts, pyogenic abscesses, and even cystic tumors of the brain, and can create diagnostic dilemmas in the musculoskeletal system.

A case of Rasmussen's aneurysm caused by pulmonary nontuberculous mycobacterium.

Rasmussen's aneurysm was originally described as a rare cause of hemoptysis in tuberculosis. Dilatation of the pulmonary artery wall is caused by tuberculosis inflammation. Recently, the incidence of non-tuberculous mycobacterial (NTM) disease has increased; it now exceeds that of tuberculosis. We report a Rasmussen's aneurysm due to NTM.

Issues in Medicine.

Rasmussen aneurysms are abnormalities of the pulmonary arterial system caused by tuberculosis (TB). They are associated with a highmortality rate when they cause life-threatening haemoptysis. High TB-prevalence regions have a large burden of TB-related haemoptysisbut often limited resources. This series of 25 patients who presented with life-threatening haemoptysis from current and/or previous TBwere found to have abnormal pulmonary arteries on computed tomography pulmonary angiogram (CTPA), which were judged to belikely contributors to their bleeding, either in isolation or with concomitant abnormal bronchial or systemic vasculature. These patientsunderwent transcatheter placement of Amplatzer vascular plugs in the feeder pulmonary artery. Bronchial and systemic lesions wereaddressed separately as needed. Immediate technical success was achieved in all patients, but four of them experienced intraoperativehaemoptysis related to dislodgement of the occluding platelet plug by the high-pressure automatic injector and wire. At 48 hours after theprocedure, 18 (72%) remained haemoptysis-free. Six of these experienced recurrence within 1 year of their procedure. Pulmonary arteryplacement of an Amplatzer vascular plug is a feasible option for treating bleeding Rasmussen aneurysms, but should be part of a combinedapproach to addressing suspected culprit vascular lesions in all intrathoracic vascular systems.

The forgotten bomb: Ramussens’s aneurysm

IntroductionRasmussen’s aneurysm is an inflammatory pseudoaneurysmal dilatation of a branch of the pulmonary artery adjacent to the tuberculous cavity. It often presents with hemoptysis resulting from its rupture. Massive hemoptysis seen in giant aneurysms is a rare but life-threatening complication of cavitary tuberculosis.AimIn this case, we aimed to present a case of giant rasmussen aneurysm that did not bleed and was diagnosed incidentally.Case studyIn this article, we present a female patient who was surprisingly diagnosed with Rasmussen’s aneurysm during her follow-up after having been admitted to our emergency department due to diabetic ketoacidosis, fever, and shortness of breath and not responding to tuberculosis treatment. She was diagnosed using multi-detector computed tomography angiography and underwent embolization with a percutaneous thrombin injection. On the day after the procedure, thoracotomy had to be performed because the pseudoaneurysm continued to show contrast enhancement on imaging. She was successfully treated with surgery.Results and discussionAlthough pulmonary artery aneurysms are rare, it should be kept in mind that they may be related to tuberculosis. Pulmonary artery aneurysms are large asymptomatic and can reach gigantic dimensions as in this case. Rupture of an aneurysm of this size can be predicted to be mortal. Percutaneous thrombin injection can be used for treatment. However, percutaneous treatment may recur in large aneurysms, in which case surgical treatment is curative.ConclusionsRasmussen aneurysm is very rare, and when it is asymptomatic, its diagnosis may be delayed until it reaches gigantic dimensions. Contrast-enhanced thorax computed tomography and especially multi-detector computed tomography angiography are helpful in diagnosis.

Endovascular embolization for Rasmussen's aneurysm with massive hemoptysis: 3 case reports and literature review

This study aimed to explore the clinical features, the methods of pulmonary vascular interventional therapy, and the outcome of Rasmussen's Aneurysm (RA) with massive hemoptysis. A retrospective analysis of three cases of RA with massive hemoptysis was accomplished from the data collected through the literature review. A search through the PubMed database could retrieve information about 45 confirmed cases of pulmonary tuberculosis patients with massive hemoptysis attributed to RA. Three controls were also included in the study for unbiased statistical analysis of the data. All the 45 patients received chest CTA examination, 31 of whom (68.9%) showed RA by angiography. Lesions were mainly located in the upper lung of the patients, with an average diameter of 6.9 ± 3.9 mm. RA is classified into 4 types: 45 patients comprised 51.1% of type A (23 cases), 17.8% each respectively type B (8 cases) and type C (8 cases), and 4.4% of type D (2 cases). Two patients refused treatment whose prognoses were unknown, and another 2 died of asphyxia resulting from massive hemoptysis. A total of the forty-one patient received further treatment: 26 of them underwent pulmonary artery embolization, 7 received bronchial artery embolization, and the rest 8 received both bronchial artery and pulmonary embolization treatment. After treatment, one of the patients died of suffocation with massive hemoptysis during the surgical procedure, 38 recovered completely, and 2 showed recurrence of hemoptysis.Pulmonary vascular interventional therapy remains the preferred intervention for the remedy of RA accompanied by massive hemoptysis.

Hemoptysis from Rasmussen's Aneurysm.

Hemoptysis from Rasmussen's Aneurysm.

Rasmussen's aneurysm: A rare cause of haemoptysis.

Rasmussen's aneurysm is a rare and life-threatening cause of recurrent hemoptysis in post tuberculosis patients. Appropriate and early treatment can prevent complications like severe life-threatening hemoptysis due to aneurysm rupture.

Intercostal Artery Aneurysm in a Child with Disseminated Tuberculosis and Coexistent Takayasu Arteritis: A Rare Case Report

Intercostal (IC) artery aneurysm due to underlying tuberculosis (TB) is very rare in adults and even rarer in children, and very few cases have been reported so far. The underlying mechanism is due to erosion of the arterial wall due to adjacent inflammation such as empyema, pericarditis, or cavitatory lesion. Aortic pseudoaneurysm or Rasmussen aneurysm is common in pulmonary TB. However, asymptomatic and incidentally detected pseudoaneurysm of the right IC artery in a child with disseminated TB is infrequent. Although the association of TB and Takayasu arteritis (TA) is well known, the association of IC artery aneurysm due to underlying TB along with TA has not been reported previously.

Thoracic Cardiovascular Complications of Tuberculosis.

Mycobacterium infection remains a leading cause of morbidity and mortality worldwide. Although rare, thoracic cardiovascular complications are associated with devastating consequences if not promptly diagnosed using computed tomography. Intrapulmonary complications include tuberculous aortitis, Rasmussen aneurysms, involvement of bronchial and nonbronchial systemic arteries, and thromboembolic events. Extrapulmonary complications include pericarditis, myocarditis, endocarditis, involvement of coronary arteries, annular-subvalvular left ventricle aneurysms and mediastinal fibrosis. This article will review these complications and their computed tomography features.

Rasmussen aneurysm in a patient from the Ukraine: A diagnostic challenge

A patient diagnosed with multi-drug resistant tuberculosis presented with a massive haemoptysis linked to a Rasmussen aneurysm. Failure to occlude the feeding artery via coil embolization was successfully managed with lung surgery.

Non-bronchial causes of haemoptysis: imaging and interventions

PurposeTo describe non-bronchial causes of haemoptysis on imaging and the role of interventional radiology in their management from cases of haemoptysis archived from our database at a tertiary care, federally funded institution.Material and methodsRetrospective analysis of cases that presented with haemoptysis in our institution from 2008 to 2013 was done, and details of cases in which the bleeding was from a non-bronchial source were archived and details of imaging and treatment were recorded.ResultsRetrospective analysis of patients presenting with haemoptysis yielded 24 (n = 24) patients having haemoptysis from non-bronchial sources. Causes of haemoptysis were: Rasmussen aneurysms (n = 12/24), costocervical trunk pseudoaneurysm (n = 1/24), left internal mammillary artery pseudoaneurysm (n = 1/24), left ventricular aneurysms (n = 3/24), pulmonary arteriovenous malformations (AVMs) (n = 5/24), and proximal interruption of pulmonary artery (n = 2/24). Imaging and interventional radiology management are described in detail.ConclusionsHaemoptysis can be from non-bronchial sources, which may be either from systemic or pulmonary arteries or cardio-pulmonary fistulas. Bronchial computed tomography angiography (CTBA), if feasible, must always be considered before bronchial artery embolisation because it precisely identifies the source of haemorrhage and vascular anatomy that helps the interventional radiologist in pre-procedural planning. This circumvents chances of re-bleed if standard bronchial artery embolisation is done without CTBA.

Aftermath of pulmonary tuberculosis: computed tomography assessment

PurposePulmonary tuberculosis (PTB) has clinically significant sequelae, even after recommended treatment completion. It is important to recognise these sequelae for accurate assessment of severity and treatment planning, if indicated.Material and methodsWe retrospectively analysed contrast-enhanced computed tomography (CT) scans of chest of 100 patients with previous history of treated pulmonary tuberculosis, excluding those with active pulmonary disease. CT findings were analysed based on parenchymal, airway, pleural, mediastinal, and vascular sequelae of PTB.ResultsParenchymal sequelae included fibrosis with architectural distortion and volume loss (90%), cavities (21%) (with aspergillomas noted in 19% of these cases), and tuberculomas (54%). Airway involvement was noted as bronchiectasis (77%) and bronchial stenosis (4%) but none with broncholithiasis. Mediastinal sequelae included lymph node calcification (74%), fibrosing mediastinitis (1%), and pericardial tuberculosis (2%). Pleural sequelae included pleural thickening (22%), with 40.9% of these patients showing calcifications, and one patient with chronic chylous pleural effusion. Vascular sequelae included Rasmussen aneurysms (4%), enlarged bronchial arteries (3%), and systemic bronchial collaterals in 1% of our patients.ConclusionsPTB has multiple appalling sequelae, which require due attention and appropriate treatment in symptomatic cases. Radiological evaluation forms an integral part in patient assessment and decision making.

Rasmussen's Aneurysm Associate With Pulmonary Artery Vascular Malformation Presented With Haemoptysis

Rasmussen's aneurysm is an inflammatory pseudo-aneurysmal dilatation of a branch of pulmonary artery associated with a cavitary lung lesion. Like any aneurysm, a Rasmussen's aneurysm is at increased risk of rupture and bleeding into the lungs. A 52 years old male presented with low-grade fever and haemoptysis, chest x-ray revealed a well margined nodular shadow with calcifications in mid zone of left lung associated with ipsilateral upper zone fibrosis and bronchiectasis. The patient had past history of pulmonary tuberculosis eight years back. For characterization of left pulmonary nodule the patient was referred to radiology and Imaging department and contrast CT scan of chest was done. Contrast CT scan of chest with reformat MIP pulmonary angiogram revealed a small pulmonary artery vascular malformation in lateral basal segment of lower lobe of left lung associated with left upper lobar cavitating lesion with fibrosis, traction bronchiectasis and Rasmussen's aneurysm arising from upper lobar apical segmental pulmonary artery. Early surgical or angiographic interventions with endovascular embolization are recommended once it be clearly diagnosed.
 KYAMC Journal Vol. 10, No.-3, October 2019, Page 168-170

A rare cause of massive hemoptysis in pulmonary tuberculosis – Rasmussen's aneurysm: A forgotten scourge

A rare cause of massive hemoptysis in pulmonary tuberculosis – Rasmussen's aneurysm: A forgotten scourge

Giant Rasmussen’s Aneurysm

Giant Rasmussen’s Aneurysm

Rasmussen aneurysm: A rare but not gone complication of tuberculosis

This report describes the case of a 30-year-old homeless man from Pereira, Colombia with tuberculosis, who presented with massive hemoptysis and associated aneurysm of the left upper lobe (Rasmussen aneurysm). Computed tomography angiography with three-dimensional reconstruction confirmed the aneurysm, and embolization was performed successfully.

Rasmussen's aneurysm.

Rasmussen's aneurysm.