Endovascular Treatment of Multiple Bronchial Artery Aneurysms With Prominent Fistula to Pulmonary Artery in a Patient With Interstitial Lung Disease: A Case Report and Literature Review

Vasc Endovascular Surg. 2019 Aug;53(6):492-496. doi: 10.1177/1538574419845184. Epub 2019 Apr 24.

Abstract

Bronchial artery aneurysm (BAA) is a rare entity. Ruptured BAA can cause life-threatening hemorrhage. It is recommended that treatment should be initiated immediately after diagnosis. We present the case of a 56-year-old female with multiple BAAs and interstitial lung disease. Aortic computed tomography angiography demonstrated that the largest aneurysm at the right hilum was fed by right subclavian artery and right bronchial artery. A fistula between the pulmonary trunk and the aneurysm was also revealed. The patient underwent transcatheter embolization. Coils were placed in the feeding vessels instead of the aneurysms to avoid nontarget embolization of the pulmonary arteries through the fistula. The procedure achieved reduction in aneurysmal blood flow. The patient's cough resolved at 6-month follow-up.

Keywords: bronchial artery aneurysm; fistula; pulmonary artery; transcatheter arterial embolization.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aneurysm / complications
  • Aneurysm / diagnostic imaging
  • Aneurysm / therapy*
  • Bronchial Arteries* / diagnostic imaging
  • Computed Tomography Angiography
  • Embolization, Therapeutic* / instrumentation
  • Endovascular Procedures* / instrumentation
  • Female
  • Humans
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / diagnostic imaging
  • Middle Aged
  • Pulmonary Artery* / diagnostic imaging
  • Respiratory Tract Fistula / complications
  • Respiratory Tract Fistula / diagnostic imaging
  • Respiratory Tract Fistula / therapy*
  • Treatment Outcome
  • Vascular Fistula / complications
  • Vascular Fistula / diagnostic imaging
  • Vascular Fistula / therapy*