Duration of Angioembolization for Rasmussen's Aneurysm
The actual embolization procedure for Rasmussen's aneurysm typically takes 30-90 minutes of fluoroscopy time, though the entire procedure including preparation, angiography, and post-procedure monitoring extends the total duration to 2-4 hours.
Procedural Timeline
Pre-Embolization Phase
- Diagnostic angiography: 15-30 minutes to identify the exact location and feeding vessels of the pulmonary artery aneurysm 1, 2
- Catheter positioning: Additional 15-20 minutes to navigate catheters to the target vessel
Active Embolization Phase
- Embolic agent delivery: The core embolization itself typically requires 30-60 minutes of active fluoroscopy time 2, 3
- Multiple embolic agents may be used, including:
Post-Embolization Assessment
- Completion angiography: 10-15 minutes to confirm complete occlusion of the aneurysm and absence of filling 4
- Observation for immediate complications: 15-30 minutes before transferring patient
Technical Considerations
The procedure duration varies based on several anatomical factors:
- Aneurysm size (larger aneurysms may require more embolic material and longer procedure times) 4
- Number of feeding vessels requiring embolization 1
- Complexity of catheter navigation in diseased, inflamed pulmonary vasculature 2
- Operator experience with endovascular techniques
Post-Procedure Monitoring
Immediate post-procedure observation: 4-6 hours in recovery for hemodynamic monitoring and assessment for rebleeding 1, 3
Hospital stay: Patients typically remain hospitalized for 24-48 hours post-embolization to ensure hemoptysis control before initiating or continuing anti-tubercular therapy 1
Critical Pitfall
Do not delay embolization for prolonged diagnostic workup - Rasmussen's aneurysm carries high mortality risk from massive hemoptysis, and once identified on CT angiography, urgent embolization should proceed within hours, not days 2, 5, 3. The diagnostic confirmation of active tuberculosis can occur concurrently or after hemoptysis control 4.