Giant Pulmonary Artery Aneurysm in Chronic Thromboembolic Pulmonary Hypertension

BACKGROUND: Multimodality imaging demonstrated a giant pulmonary trunk aneurysm complicating chronic thromboembolic pulmonary hypertension using invasive pulmonary angiography, contrast-enhanced computed tomography, and 3-dimensional reconstruction. CASE SUMMARY: A 49-year-old woman with antiphospholipid syndrome, systemic lupus erythematosus, and chronic thromboembolic pulmonary hypertension presented with progressive dyspnea. Imaging revealed a giant 79-mm pulmonary trunk aneurysm with severe pulmonary hypertension. This rare presentation illustrates the interaction between chronic hemodynamic stress and immune-mediated vascular injury contributing to aneurysm formation. TAKE-HOME MESSAGE: Multimodality imaging provides critical anatomical and hemodynamic information for individualized assessment of this rare complication.