Endovascular Stent-Graft Exclusion for the Treatment of Haemoptysis Caused by Central Pulmonary Artery Pseudoaneurysm: A Case Report.

Pulmonary artery pseudoaneurysm (PAP) is a rare lethal disease; central tuberculous PAP carries a mortality rate of 50%-90% and often responds poorly to conventional embolization. We report a 59-year-old tuberculous woman with recurrent haemoptysis secondary to left main PAP. Covered stent-graft exclusion was conducted after failed conservative treatment and bronchial artery embolization, with complete haemostasis and no recurrence at 1-year follow-up. Most existing literature adopts vessel-occlusive embolization for PAP, which may cause pulmonary infarction. Moreover, stent-graft implantation for main pulmonary artery lesions is seldom reported due to dimensional mismatch between large native main pulmonary arteries and commercially available covered stent-grafts (maximum diameter 12 mm). Our case uniquely confirms that precise preoperative vascular measurement allows successful deployment of a 12 mm stent-graft within the 11 mm proximal arterial segment, providing rare long-term follow-up evidence of durable haemostasis and preserved pulmonary patency via this vessel-preserving intervention strategy for central PAP.