Rare Cases of Bronchial Aneurysm and Comparison of Interventional Embolization in the Treatment of True Bronchial Aneurysm and Pseudobronchial Aneurysm

Abstract

BackgroundBronchial 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 MethodsEmbolization 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.ResultsCase 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.ConclusionEndovascular 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.

Case Report: Combined transcatheter arterial embolization and aortic stent-graft have better efficacy for bronchial artery aneurysms

“…According to reports, the etiology of BAA may be associated with hereditary factors, such as pulmonary sequestration and pulmonary artery agenesis. Additionally, acquired factors such as atherosclerosis, bronchiectasis, tuberculosis, and sepsis have been suggested as etiology ( 12 ). In the review, the most common cause for patients was bronchiectasis (19/85), followed by tuberculosis (7/85) and hypertension (6/85), which corroborates the findings of previous studies.…”

“…This necessitates urgent intervention for these patients. So far, there are no standardized diagnostic and therapeutic guidelines for BAA, resulting in the use of a variety of diagnostic and therapeutic approaches (12). CT angiography stands out as the most frequently employed imaging modality for BAA diagnosis, with previous studies showing promise in MRI techniques (1,18).…”

Pulmonary ligament rupture due to a bronchial artery aneurysm-induced hematoma: a case report

“…BAE is a well-established, minimally invasive endovascular procedure with a high success rate [ 4 ]. However, its universal applicability remains controversial; aortic stent grafting may be more appropriate for aneurysms close to the bronchial artery opening or those with a short neck [ 9 ]. In our case, BAE was indicated by the considerable distance between the proximal bronchial artery and aneurysm.…”