Imaging Pearls ❯ Vascular ❯ Intercostal Arteries
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- Intercostal Artery Pseudoaneurysm: Causes
- TAVR Procedure
- Trauma
- Coarctation of the Aorta Repair
- Open Thoracic Aneurysm Repair
- Neurofibromatosis Type 1 - “Vasculopathy associated with neurofibromatosis type 1 (NF-1) can cause a spontaneous hemothorax, which is an uncommon but life-threatening complication of the disease. We report a case of recurrent rupture of intercostal artery aneurysms in an NF-1 patient. A 40-year-old man with NF-1 suffered from a right spontaneous hemothorax. The bleeding source was not identified by dynamic contrast-enhanced computed tomography (CT), so he was initially treated by conservative therapy. However, repeated contrast CT revealed aneurysms of the right 10th intercostal artery. They were successfully occluded by transcatheter arterial embolization (TAE). Seven months afterward, he presented with sudden lower back pain and was diagnosed with a contralateral spontaneous hemothorax due to a ruptured aneurysm of the left 12th intercostal artery.”
Recurrent rupture of intercostal artery aneurysms in neurofibromatosis type 1.
Misao T et al. Gen Thorac Cardiovasc Surg. 2012 Mar;60(3):179-82. - “Intercostal aneurysms associated with coarctation can have significant consequences including late rupture, paralysis, and even death. These aneurysms are common with an incidence of up to 40% with adult-diagnosed coarctation; one treatment plan is to treat both the coarctation and aneurysm during a single catheterization. Pre-catheterization CT or MRI may play a role in this strategy.”
Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key.
Batlivala SP, Rome JJ1 Cardiol Young. 2016 Feb;26(2):390-5 - “Intercostal aneurysms are associated with aortic coarctation. Their aetiology is not well-understood but may be related to intrinsic vascular pathology and altered flow dynamics through the intercostal artery. We present the cases of two patients with coarctation and intercostal aneurysms. The aneurysms were recognized on pre-catheterization imaging studies and were selectively occluded during the same procedure to treat the coarctation. There were no complications; both the patients have no residual coarctation at the most recent follow-up.”
Concomitant percutaneous treatment of aortic coarctation and associated intercostal aneurysms: pre-procedural recognition is key.
Batlivala SP, Rome JJ1 Cardiol Young. 2016 Feb;26(2):390-5