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Lin JL, Ji YY, Zhang MZ, Tang Y, Wang RL, Ruan DD, Zhou YF, Wu SJ, Cai SL, Zhang JH, Meng XR, Luo JW, Fang ZT. Rare Cases of Bronchial Aneurysm and Comparison of Interventional Embolization in the Treatment of True Bronchial Aneurysm and Pseudobronchial Aneurysm. Front Cardiovasc Med 2022; 9:856684. [PMID: 35355974 PMCID: PMC8959610 DOI: 10.3389/fcvm.2022.856684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Background Bronchial artery aneurysm (BAA) is a rare disease. Rupture of BAA can lead to life-threatening hemoptysis, and once diagnosed, treatment is needed regardless of symptoms. Transcatheter artery embolization is the first choice of treatment because it is minimally invasive and effective. This study aimed to retrospectively compare the embolization treatment of a case of true BAA and that of a pseudobranchial aneurysm and explore the choice of embolization method for BAA with short neck or no neck. Materials and Methods Embolization treatment and imaging characteristics of one case of true BAA and one case of pseudobronchial aneurysm admitted to our hospital were analyzed retrospectively. Embolization methods and therapeutic effects of two cases of BAAs were compared. Results Case 1 was that of an intact true BAA inside the mediastinum located at the opening of the bronchial artery. The distal end of the aneurysm was embolized, and tumor cavity was occluded. No recurrence of BAA was found after the operation. Case 2 was that of a ruptured and hemorrhagic pseudobronchial aneurysm of the mediastinum. Coil embolization combined with covered stent graft exclusion of the thoracic aorta were performed, and the left bronchial artery and BAA were almost occluded. Nine months postoperatively, the mediastinal hematoma was almost completely absorbed. Conclusion Endovascular embolization has become the most commonly used for the treatment of BAA. Different methods should be selected according to the location and nature of the aneurysm.
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Affiliation(s)
- Jia-Li Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yuan-Yuan Ji
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Ming-Zhe Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yi Tang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Ruo-Li Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Dan-Dan Ruan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yan-Feng Zhou
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Shao-Jie Wu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Sen-Lin Cai
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Jian-Hui Zhang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Rong Meng
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Jie-Wei Luo
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- *Correspondence: Jie-Wei Luo,
| | - Zhu-Ting Fang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
- Zhu-Ting Fang,
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Chen Y, Qin W, Zhu Z, Wang X, Yu W, Li F, Li C. Interlocking detachable coil embolization for giant tandem bronchial aneurysms: A case report. Medicine (Baltimore) 2021; 100:e28416. [PMID: 34941187 PMCID: PMC8702262 DOI: 10.1097/md.0000000000028416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 12/06/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Bronchial artery aneurysm (BAA) is a rare disease that can be life-threatening if it ruptures. Tandem connections of multiple aneurysms are even rarer and more challenging to manage. PATIENT CONCERNS A 46-year-old woman presented to the hospital with intermittent hemoptysis for a week. A bronchial artery computed tomographic angiography scan revealed 2 BAAs associated with bronchial artery-to-pulmonary artery fistulas in the left lung. Three-dimensional CT reconstruction showed 2 bronchial aneurysms in tandem and 1 aneurysm adjacent to the descending aorta. DIAGNOSES Giant tandem bronchial aneurysms were confirmed using computerized tomographic angiography. INTERVENTIONS Nine interlocking detachable coils and 11 standard pushable coils were introduced into aneurysms for embolization. OUTCOMES There was no episodes of hemoptysis. CT angiography indicated that the coils were closely knit and in their proper position 1 month later; at follow-up, the patient had no adverse effects and no recurrence of hemoptysis. LESSONS BAA is a rare disease that can be life-threatening if it ruptures. It should be treated aggressively to determine the presence of symptoms.
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Affiliation(s)
- Yingjie Chen
- School of Medicine, Jianghan University
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
| | - Wei Qin
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Ziyang Zhu
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Xiaojiang Wang
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Wei Yu
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Fajiu Li
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
| | - Chenghong Li
- Department of Pulmonary and Critical Care Medicine, Pulmonary Vascular Interventional Centre, Hemoptysis Centre, Affiliated Hospital of Jianghan University
- Institution of Pulmonary Vascular Disease, Jianghan University, China
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Kikutani K, Itai J, Ota K, Chosa K, Yamane Y, Shime N. A Ruptured Mediastinal Bronchial Artery Aneurysm Treated with Urgent Thoracic Endovascular Aortic Repair. Intern Med 2020; 59:1283-1286. [PMID: 32074575 PMCID: PMC7303459 DOI: 10.2169/internalmedicine.4004-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Bronchial artery aneurysms (BAA) are a rare but potentially life-threatening complications because of the massive hemothorax or hemoptysis that occurs with ruptures. A 79-year-old woman was transferred to our hospital because of the sudden onset of back pain, syncope, and subsequent hypotension. Computed tomography showed a left BAA with bilateral hemothorax and hemomediastinum. Transcatheter bronchial artery embolization failed because of the anatomical location, and she went into cardiopulmonary arrest. Cardiopulmonary resuscitation was performed with successful revival. Urgent thoracic endovascular aortic repair to cover the root of the left bronchial artery was successful, and she survived without any neurological deficits.
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Affiliation(s)
- Kazuya Kikutani
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Junji Itai
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Kohei Ota
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
| | - Keigo Chosa
- Department of Diagnostic Radiology, Hiroshima University, Japan
| | - Yoshitaka Yamane
- Department of Cardiovascular Surgery, Hiroshima University School of Medicine, Japan
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan
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