Endovascular Therapy of Bronchial Artery Aneurysm: Five Cases With Six Aneurysms

Abstract

The objective of this study was to investigate the effect of transcatheter arterial embolization (TAE) with N-butyl-2-cyanoacrylate (NBCA)-Lipiodol mixture in patients with bronchial artery aneurysm (BAA). From January 2005 to January 2010, five patients presenting hemoptysis with six BAAs were treated with NBCA-Lipiodol mixture, including intra-aneurysm embolization (IAE) in one patient. Adjuvant embolization with spherical polyvinyl alcohol (PVA) embolic microparticles or NBCA was first performed to embolize the distal engorged bronchiectatic arteries. Bronchial arterial angiography showed six BAAs (four in the right lobe and two in the left lobe) and some engorged, tortuous bronchial arteries. TAE through microcatheter was successful in all cases. Postembolization angiogram demonstrated the NBCA cast and total occlusion of BAAs and bronchiectatic engorged vessels. After these procedures, hemoptysis completely disappeared in all patients. Follow-up computed tomography (CT) scan was performed at an average of 3 months (range 2 to 6), which showed no enhancement of BAAs and accumulation of NBCA. TAE is a minimally invasive, effective, and reliable approach for treatment for patients with BAA. NBCA-Lipiodol mixture provides a good choice for treatment of BAA, especially when catheterization of the efferent branches is impossible.

Coil embolization of bronchial artery aneurysm with high flow bronchial artery-pulmonary artery fistula

“…Previous reports described managing similar situation with N-butyl-2-cyanoacrylate (NBCA) [9,10]. In our case, catheter could reach the efferent artery but not to the fistula.…”

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

“…It has been suggested that both increased bronchial arterial flow and focal weakening of the vessel wall contribute to the pathogenesis of BAA. [2] Our analysis of the relevant literature revealed that BAA was most commonly associated with bronchiectasis (Fig. 6), with other factors being hypertension, chronic obstructive pulmonary disease vasculitis, chronic bronchopulmonary infection, tuberculosis, and trauma.…”

Combination of Aortic Stent Grafting and Arterial Embolization for Bronchial Artery Aneurysm Associated with Bronchial–Pulmonary Arterial Fistula

“…The most common symptom of intrapulmonary BAA is hemoptysis, whereas mediastinal BAA presents with a variety of symptoms caused by compression of the adjacent structures, such as hemoptysis, dysphagia, hoarseness, superior vena cava syndrome, and severe chest pain mimicking acute aortic dissection caused by rupture (3,4). Therefore, the asymptomatic nature and incidental diagnosis of mediastinal BAA in the present case are rare.…”

“…Editor: An infected aortic aneurysm is an uncommon but potentially fatal condition, and endovascular techniques are increasingly being recognized as an alternative to surgery (1,2). Covered endovascular reconstruction of aortic bifurcation (CERAB) is an endovascular technique used in the treatment of chronic occlusive aortoiliac disease (3,4). We modified the CERAB technique to treat a patient with an infected aortic aneurysm.…”