Tuberc Respir Dis.  2008 Dec;65(6):546-549.

A Case of Bronchial Artery Aneurysm with Bronchiectasis and Successful Coil Embolization

• Chung HJ
• Cho JH
• Park BD
• Ryu JS
• Kwak SM
• Lee HL
• Jeon YS

Abstract

Bronchial artery aneurysm (BAA) is a rare entity that requires early diagnosis and immediate treatment due to the possibility of a life-threatening massive hemorrhage through rupture. The standard treatment is a surgical resection of the aneurismal artery. However, various embolization techniques, including coil embolization, are currently used as the optimal treatment because they are less invasive. A 65-year-old woman was referred for the treatment of intermittent hemoptysis. A chest CT scan showed an approximately 2 cm sized vascular mass with strong contrast enhancement originating from the right bronchial artery on the bronchiectatic parenchyma. On the angiogram, the inferior portion of the bronchial artery with a hypertrophic aspect and a huge bronchial artery aneurysm was detected on the left side branch. The bronchial artery aneurysm was embolized successfully with coils at the proximal and distal portion of the aneurysm. After coil embolization, the selective bronchial angiogram confirmed complete occlusion. We report this case of a bronchial artery aneurysm that was treated successfully with coil embolization.

Keyword

Bronchial artery aneurysm; Bronchiectasis; Coil embolization

MeSH Terms

Aged
Aneurysm
Arteries
Bronchial Arteries
Bronchiectasis
Early Diagnosis
Female
Hemoptysis
Hemorrhage
Humans
Rupture
Thorax

Figure

• 

  Figure 1 (A, B) Chest CT shows a huge bronchial artery aneurysm (BAA) in Rt. bronchial artery. About 2 cm sized, well-defined, mass is noted in right middle lobe area on axial image. (C) On oblique coronal MPR view, right bronchial artery is originated from thoracic aorta, and BAA is seen in left side of its branch. (D) VRT image demonstrates vascular structure between Rt. bronchial artery and BAA.

• 

  Figure 2 Selective right bronchial angiogram shows bronchial artery hypertrophy and huge bronchial artery aneurysm.

• 

  Figure 3 A bronchial artery aneurysm is successfully embolized with coils at proximal and distal portion of aneurysm (aneurysm is not seen).

• 

  Figure 4 Follow up chest CT was performed 4 weeks later after embolization. Metal stent coils' shadowing is seen. No more bronchial artery aneurysm is detected.

Reference

1. Aburano H, Kawamori Y, Horiti Y, Kitagawa K, Sanada J, Matsui O. Bronchial artery aneurysm embolization with NBCA. Cardiovasc Intervent Radiol. 2006. 29:1141–1143.

2. Sakai T, Razavi MK, Semba CP, Kee ST, Sze DY, Dake MD. Percutaneous treatment of bronchial artery aneurysm with use of transcatheter coil embolization and thoracic aortic stent-graft placement. J Vasc Interv Radiol. 1998. 9:1025–1028.

3. Choi HJ, Ok KS, Jung SM, Lee YM, Kang YK, Jin JY, et al. A case of bronchial artery aneurysm presenting with massive hemoptysis. Tuberc Respir Dis. 2002. 52:86–91.

4. Yanagihara K, Ueno Y, Kobayashi T, Isobe J, Itoh M. Bronchial artery aneurysm. Ann Thorac Surg. 1999. 67:854–855.

5. Kalangos A, Khatchatourian G, Panos A, Faidutti B. Ruptured mediastinal bronchial artery aneurysm: a dilemma of diagnosis and therapeutic approach. J Thorac Cardiovasc Surg. 1997. 114:853–856.

6. Choi SY, Ahn C, Min SK, Han JJ, Ahn JH, Won T. A giant bronchial artery aneurysm in bronchiectatic patient: one case report. Korean J Thorac Cardiovasc Surg. 2004. 37:951–954.

7. Tanaka K, Ihaya A, Horiuci T, Morioka K, Kimura T, Uesaka T, et al. Giant mediastinal bronchial artery aneurysm mimicking benign esophageal tumor: a case report and review of 26 cases from literature. J Vasc Surg. 2003. 38:1125–1129.

8. Jacobi M. Aneurysm of the bronchial arteries. Am Heart J. 1930. 5:795–780.

9. Hong SA, Ha TH, Lyu JW, Kim YK, Lee YM, Kim KU, et al. A case of bronchial artery aneurysm demonstrating hilar mass. Tuberc Respir Dis. 2007. 62:62–66.

10. Servois V, Denys A, Silbert A. Mycotic aneurysm of the bronchial artery: a rare cause of hemoptysis. AJR Am J Roentgenol. 1992. 159:428.

11. Sancho C, Domínguez J, Escalante E, Hernandez E, Cairols M, Martinez X. Embolization of an anomalous bronchial artery aneurysm in a patient with agenesis of the left pulmonary artery. J Vasc Interv Radiol. 1999. 10:1122–1126.

12. Cearlock JR, Fontaine AB, Urbaneja A, Spigos DG. Endovascular treatment of a posttraumatic bronchial artery pseudoaneurysm. J Vasc Interv Radiol. 1995. 6:495–496.

13. Sbano H, Mitchell AW, Ind PW, Jackson JE. Peripheral pulmonary artery pseudoaneurysms and massive hemoptysis. AJR Am J Roentgenol. 2005. 184:1253–1259.