Intralobar pulmonary sequestration with aberrant feeding artery aneurysm

Pulmonary sequestration (PS) is a rare congenital lung malformation in which nonfunctioning lung tissue is supplied by systemic arteries without normal bronchial communication. Development of aneurysms within the aberrant feeding artery is exceedingly uncommon and associated with high risk of rupture. Computed tomography angiography (CTA) is the primary modality for diagnosis, offering precise assessment of anomalous systemic supply, venous drainage, and aneurysmal changes, particularly when complemented with 3-dimensional (3D) reconstruction techniques. We report the case of a 67-year-old male with a history of recurrent pneumonia and intermittent hemoptysis. Imaging revealed left lower lobe intralobar sequestration supplied by an aberrant artery originating from the aortic arch, complicated by a 3.0 cm saccular aneurysm. Advanced visualization with 3D printing and Global Illumination Rendering (GIR) provided detailed delineation of vascular anatomy and facilitated multidisciplinary surgical planning. The patient underwent successful endovascular treatment with coil embolization and covered stent placement. At 1.5 years follow-up, the aneurysm remained stable with complete thrombosis and no recurrence of symptoms. This case highlights the clinical importance of recognizing aneurysmal transformation in intralobar sequestration and demonstrates how advanced imaging tools can optimize preoperative planning. Endovascular management offers a minimally invasive and effective alternative to conventional surgical resection in selected patients.