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Systemic bronchial arterial circulation is the most common source for massive hemoptysis. Rarely, the source of bleeding can be the pulmonary artery. We report 2 different case scenarios of massive hemoptysis due to different etiologies, in which the source of bleeding was the pulmonary artery. Both the patients were treated with percutaneous transcatheter embolotherapy using coils. The 2 cases highlight the importance of considering pulmonary arterial etiology as the cause of hemoptysis while reporting diagnostic computed tomography studies and tailoring the interventional technique toward performing pulmonary angiography instead of searching for a systemic arterial source for hemoptysis.

Leiomyosarcoma of inferior vena cava (IVC) is a very rare tumor constituting less than 1% of all malignant tumors. However, it is the most common malignant primary IVC tumor. We report a case of primary leiomyosarcoma involving the entire IVC and extending into the right atrium. We also describe a simple endovascular technique that can be used to biopsy IVC masses through a transvenous approach. Our technique can be used as an alternative to percutaneous biopsy which carries a risk of bleeding when transgressing the IVC wall with a biopsy needle. To our knowledge, the use of this technique to biopsy IVC masses has not been described in literature.