Aortic Stent-Graft for a Giant Bronchial Artery Aneurysm with Ultrashort Neck

Kim, Yoon Kyung; Sung, Yon Mi; Kim, Jeong-Ho; Byun, Sung Su; Park, Young Nam; Lee, Sang Pyo

doi:10.5761/atcs.cr.12.02117

Cited by 11 publications

(13 citation statements)

References 9 publications

(18 reference statements)

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“…Thoracic aortic endovascular repair was selected to solve the short neck issue, as reported in 9 articles. [4,12–19] In our case, we chose to implant a stent across the ectopic bronchial artery to avoid movement of the interlocking coils. To our best knowledge, this is the first time that combined TAE and stent was used in treating BAA.…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization

Chen

et al. 2016

Medicine

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Background:Bronchial artery aneurysm (BAA) is an uncommon but potentially life-threatening disease, and multiple BAAs are even rarer. Clinically, the tortuous and short neck of a BAA may present significant challenges for invasive intervention.Methods:This report describes the detailed process of diagnosis and treatment and includes a literature review of the etiology, clinical presentation, and therapeutic management of BAA.Results:A rare case of multiple BAAs, with one having an inflow artery arising from the brachiocephalic trunk, was referred to our hospital. The patient was successfully treated with coil embolization and brachiocephalic artery stent placement. In addition, we conducted a literature review involving 63 cases of BAA. BAA was most commonly associated with bronchiectasis and was located predominantly in the mediastinum. There was no significant difference between the diameters of the ruptured aneurysms and those of the nonruptured aneurysms (P = 0.115). Transcatheter arterial embolization was the most commonly adopted technique to treat BAA, while thoracic aortic endovascular repair was selected if the neck between the aneurysm and the aorta was short. Subgroup analysis suggested that patients with > 1 BAA were significantly more likely to be female than male (χ2 test, P = 0.034).Conclusion:Transcatheter coil embolization combined with stent placement could be a reasonable treatment option for BAAs with a tortuous and short neck. According to our literature review, patients with multiple BAAs display distinctive clinical characteristics compared with patients with a single BAA.

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Section: Discussionmentioning

confidence: 99%

Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization

Chen

et al. 2016

Medicine

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“…However, it is difficult to achieve complete embolization in cases where the vascular segment between the aneurysm and aorta is short. 4 ) Revascularization of BAA is also reported by collateral vessels, incomplete embolization, and arterial re-canalization. 1 , 4 ) In addition, in cases where the neck of BAA is branched from the anterior surface of the descending aorta, the possibility of distal embolization is significant.…”

Section: Discussionmentioning

confidence: 98%

“…Since the retrograde blood flow to the aneurysm from the outflow vessel may remain, some authors recommended that TAE should be considered with the stent graft simultaneously. 1 , 2 , 4 ) Although the follow-up period was short, Kasashima et al 6 ) and Arici et al 10 ) reported acceptable results using stent graft treatment alone. We also examined TAE in our case; it seemed too technically demanding because there are multiple, thin, and tortuous inflow arteries.…”

Section: Discussionmentioning

confidence: 99%

Bronchial Artery Aneurysm Treated Using Aortic Stent Graft Alone: A Case Report

Matsumoto

Uchida

Ono

et al. 2017

Annals of Vascular Diseases

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A 72-year-old woman with a history of malignant lymphoma was referred to our hospital for the treatment of a bronchial artery aneurysm. Computed tomography (CT) scan showed a round, 30 mm-diameter fusiform aneurysm with two tortuous inflow arteries. We deployed thoracic stent grafting to cover the orifice of the two inflow arteries without transcatheter bronchial arterial embolization. Postoperative CT scan revealed complete thrombosis of the aneurysm. Although further follow-up is mandatory, this may be considered a viable treatment option in cases wherein the bronchial artery aneurysm is anatomically difficult to treat.

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“…TAE is often the first choice for a ruptured BAA because of its low invasiveness, although it is sometimes difficult when the aneurysm has a short neck. In such cases, previous studies reported the successful treatment effects of a stent graft for BAA (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) (Table). However, most of the treatments in these previous studies were indicated for an unruptured BAA, while only two reports indicated a ruptured BAA (8,15).…”

Section: Discussionmentioning

confidence: 99%

A Ruptured Mediastinal Bronchial Artery Aneurysm Treated with Urgent Thoracic Endovascular Aortic Repair

et al. 2020

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Bronchial artery aneurysms 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 bronchial artery aneurysm 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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Aortic Stent-Graft for a Giant Bronchial Artery Aneurysm with Ultrashort Neck

Cited by 11 publications

References 9 publications

Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization

Endovascular treatment of ectopic bronchial artery aneurysm with brachiocephalic artery stent placement and coil embolization

Bronchial Artery Aneurysm Treated Using Aortic Stent Graft Alone: A Case Report

A Ruptured Mediastinal Bronchial Artery Aneurysm Treated with Urgent Thoracic Endovascular Aortic Repair

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