Iatrogenic Pulmonary Artery Pseudoaneurysm Following Swan-Ganz Catheterization: Successful Endovascular Coil Embolization

Pulmonary artery pseudoaneurysm (PAPA) is a rare but life-threatening complication of Swan-Ganz catheterization. We report the case of a 71-year-old woman with severe pulmonary hypertension, mechanical mitral valve replacement requiring chronic anticoagulation, and chronic obstructive pulmonary disease who developed moderate hemoptysis within hours of Swan-Ganz catheterization. Computed tomography angiography (CTA) demonstrated a 12 mm pseudoaneurysm arising from a subsegmental branch of the right middle lobe pulmonary artery with surrounding alveolar hemorrhage, absent on admission imaging. Interventional radiology performed successful endovascular coil embolization using a sandwich technique, with complete resolution of hemoptysis within 24 hours of the procedure. This case highlights the importance of recognizing PAPA as a cause of post-catheterization hemoptysis, the critical role of CTA in diagnosis, and the effectiveness of endovascular coil embolization as the preferred minimally invasive treatment approach.